Do It Yourself Guide to Identification - page 22

Hea l th Card
ALBERTAPERSONAL
22
UnitedWayof Calgary andArea,March 2014
If youneed to replaceyourAlbertaPersonalHealthCard, youwill be required toprovide
your full name, mailing address, telephone number andpersonal health number. If you
do not know your personal health number, you will need to provide other security
information such as your date of birth. Additionally, for security reasons you may be
required to provide proof of identity. If you have hadmany replacement health cards
issued in thepast, youmaybeasked tocompleteaStatutoryDeclaration regardingyour
identity.
If Alberta Healthmade attempts to contact youwith no response, your AHCIP number
may be temporarily suspended. If this happens, you need tomake contact withAlberta
Health andupdate the information required tohave your AHCIPnumber re-activated.
Apply:
• Inperson at aparticipating registry agent
•Bymail
•By fax
Required Information:
• Full legal name
•Gender
•Dateof birth
•Marital status
•Dependents
Additional InformationRequested:
•Mailing address and telephone number of applicantmust beprovided
•CanadianCitizenshipStatus
• PreviousAHCIP
•Why are you applying?
•Where andwhendid you arrive inAlberta?
• Registrant declaration
Requirements:
• Proof of identity
• Proof of entitlement tobe inCanada
• Proof of Alberta residency
Contact Information:
•Website:
• Tel: Toll freeby dialing 310-0000 then (780) 427-1432
• Fax: (780) 422-0102
•MailingAddress: AlbertaHealth
Attention: AlbertaHealthCare InsurancePlan
POBox 1360, StationMain
EdmontonABT5J 2N3
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