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A-506 Nunavut Health Care Coverage Application Form

A-506 Nunavut Health Care Coverage Application Form

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Nunavut Health Care Coverage Application Form

Applicants moving to Nunavut from within Canada must attach a clear copy of the following to this form; Birth Certificate & Health Care Card (from the Province / Territory you are currently registered in)
You may also be requested to provide additional information such as: employment contract and or proof of residency documents
Applicants moving to Nunavut from outside Canada must attach a copy of official Immigration Documents. (Readable photocopies of originals will be accepted)
For further detailed inforamtion on this application or other programs, please visit our website - @email

A: Name of Person to be Registered for Health Coverage (must be a permanent resident)
* In the "Ethnicity" box, enter one of the following numbers: 1 - Inuit 2 - Registered Indian 3 - All Others

If you entered # 1 or #2 in the "ethnicity" box, please refer to Section I for clarification.

B: Mailing Address & Contact Numbers (Cannot accept General Delivery address in Iqaluit)

C: To avoid delays, please answer ALL of the following questions.

How long do you plan to live in Nunavut?
Have you moved to Nunavut from outside Canada?
Reason for move to Nunavut.
Have all you immediate family members moved with you to Nunavut?
Have you recently left one of the following; Canadian Armed Forces - Federal Penitentiary?

Steps

  • Nunavut Health Care Coverage Application Form
  • D. Declaration
  • Registration Information
  • Preview
  • Complete
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