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eNotice of Change

This form is to report the changes listed below. Please answer as many of these questions as you can

Reported Changes

Cardholder's Information

Change of Address

Moving Out of Manitoba

Removal of Dependant(s)

Change Sex Designation


Attach a copy of your updated Manitoba Birth Certificate or Change of Sex Designation Certificate from Manitoba Vital Statistics Branch.

All documents submitted must be .jpg or .jpeg files and no larger than 3MB each in size.

If you experience issues submitting your form please contact Manitoba Health's Insured Benefits Branch at 204-786-7101 or toll free 1-800-392-1207

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