2010 medical information and treatment authorization form

Info. on filling out the form:

Alberta Health Care Insurance Plan number (if you lost your card).

Here's the number for the Ministry of Health and Wellness. Call the plan directly 780-427-1432 for assistance.

It is possible that Alberta Registries offices can also assist but call the above number first for information as they often do not deal with health insurance enquiries.

Additional information is available at this link:

Doctor’s Address or Office Name:

Enter your Dr's name in the box "Find a physician by name" here.