Alberta Health Care Insurance Plan
All new and returning Alberta residents should register for Alberta Health Care Insurance Plan (AHCIP) coverage to receive insured hospital and physician services.
This completed form and supporting documentation can be brought in in person to our office for processing.
- To receive coverage you will need to provide documentation to prove you are a resident and entitled to coverage
- Adults and their dependents (children) are covered on one account. With each new dependent, please update your AHCIP information
- Alberta Health Care Insurance Plan registration forms are available in our office or online at Alberta Health Care website
This completed form and supporting documentation can be brought in in person to our office for processing.
Please be aware that you are not covered for medical services under the AHCIP until all the required information is received and your application is processed. However, any medical services you receive and pay for before your application is processed, may be reimbursed once you have your personal health card, and can show eligibility for the period when you receive the services.
Once registered, you and your dependents are each provided with a personal health card which indicates your personal health care number.
Once registered, you and your dependents are each provided with a personal health card which indicates your personal health care number.
Trouble opening or completing PDF forms?
Fillable forms do not open properly on some mobile devices and web browsers. To fill in and save this form:
Fillable forms do not open properly on some mobile devices and web browsers. To fill in and save this form:
- Right click on the PDF link to save it on your computer.
- Launch Adobe Reader.
- Open the PDF from within Adobe Reader. You can now fill and save your form.
For more information regarding Alberta Health Care Insurance Plan, please refer to the Alberta government site.