Alberta Health Care Insurance Plan Notice of ChangeDeletion November 2012 Delete persons from AHCIP -2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal information as shown on your Alberta Personal Health Card. Fill in your last name, first name, date of birth, and gender. Ensure all details are accurate.
3. If you are deleting a spouse or adult interdependent partner, provide their details including last name, first name, date of birth, and reason for deletion. Select the appropriate reason from the options provided.
4. For each dependant you wish to delete, repeat the process by filling in their personal information and reason for deletion. If there are more than four dependants, include their information on a separate page.
5. Review all entered information for accuracy. Sign and date the declaration section at the bottom of the form to confirm that all information is true and correct.

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