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How to use or fill out the Northwest Territories Health Care Card Renewal Form online
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Click ‘Get Form’ to open the Northwest Territories Health Care Card Renewal Form in our editor.
Begin with Section A, 'Applicant Information.' Fill in your last name, first name, middle name, date of birth, and NWT Health Care Card number. Ensure all personal details are accurate.
Provide your primary and alternate phone numbers, preferred language, and email address. This information is crucial for communication regarding your application.
Complete your residential address and mailing address if different. Make sure to include apartment number, street name, city, province/territory, and postal code.
In Section B, read the declaration carefully. Confirm your intent to reside in the NWT and sign where indicated. Remember that individuals aged 19 or older must sign their own form.
Review all sections for accuracy before submitting. You can email the completed form to healthcarecard@gov.nt.ca or fax it to 867-777-3197.
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