A-29, r. 1 - Regulation respecting eligibility and registration of persons in respect of the Régie de l’assurance maladie du Québec

Section 14 Disposition versions

2013-10-10

14. To register with the Board, a person shall apply in writing, using the form supplied by the Board for that purpose, and shall provide the following information:

(1)  the person’s surname at birth, usual given name, date of birth, sex and civil status;

(1.1)  an indication as to whether or not the person is a Canadian citizen;

(2)  the spouse’s surname, if the person is a woman married in Québec before 2 April 1981 or married outside Québec who legally exercises her civil rights under her spouse’s surname and wishes that name to appear on her health insurance card;

(3)  the person’s domiciliary address or, if the person is a temporary resident of Québec, the residential address; if the person is homeless, the address of the local employment centre of the Ministère de l’Emploi et de la Solidarité sociale or the address of an institution

(4)  the person’s telephone number, where applicable;

(5)  the person’s social insurance number, where applicable;

(6)  where applicable, the person’s date of arrival in Québec, date of settlement in Québec, last country of residence or last province of residence in Canada and health insurance number issued by the last province of residence, if available;

(7)  where the person returns to Québec to take up residence again, the date of departure from and date of arrival in Québec, the date of establishing his domicile in Québec, the last country or province of residence, the date of arrival at that destination, the health insurance number assigned by the Board and, where applicable, the health insurance number issued by the last province of residence, if available;

(8)  where the person returns to Québec after having stayed outside Québec, the dates of departure from and arrival in Québec, and the reason for and place of the stay and the date of arrival at that destination;

(9)  in the event where he is staying in Québec temporarily, the reason for and expected duration of the stay;

(10)  in the case of the registration of a dependent person after that person’s birth or adoption, the surname, including the usual given name, and the domiciliary address or, if the dependant is a temporary resident of Québec, the residential address, and telephone number, date of birth, sex and civil status of either parent or both parents as well as their social insurance numbers and health insurance numbers if available;

(11)  a signed and dated statement from the person or the person’s representative attesting that all the information provided is accurate.

O.C. 1470-92, s. 14; O.C. 505-96, s. 6; O.C. 552-2001, s. 9; O.C. 944-2013, s. 4.

2012-09-01

14. To register with the Board, a person shall apply in writing, using the form supplied by the Board for that purpose, and shall provide the following information:

(1)  the person’s surname at birth, usual given name, date of birth, sex and civil status;

(1.1)  an indication as to whether or not the person is a Canadian citizen;

(2)  the spouse’s surname, if the person is a woman married in Québec before 2 April 1981 or married outside Québec who legally exercises her civil rights under her spouse’s surname and wishes that name to appear on her health insurance card;

(3)  the person’s domiciliary address or, if the person is a temporary resident of Québec, the residential address; if the person is homeless, the address of the local employment centre of the Ministère de l’Emploi et de la Solidarité sociale or the address of an institution

(4)  the person’s telephone number, where applicable;

(5)  the person’s social insurance number, where applicable;

(6)  where applicable, the date of the person’s arrival in Québec, his last country or province of residence and the health insurance number of his last province of residence;

(7)  where the person returns to Québec to take up residence, the date of departure from and arrival in Québec, the last country or province of residence, the date of arrival at that destination and, where applicable, the health insurance number of the last province of residence;

(8)  where the person returns to Québec after having stayed outside Québec, the dates of departure from and arrival in Québec, and the reason for and place of the stay and the date of arrival at that destination;

(9)  the reason for and expected duration of the stay in Québec, where applicable;

(10)  in the case of the registration of a dependent person after that person’s birth or adoption, the surname, including the usual given name, and the domiciliary address or, if the dependant is a temporary resident of Québec, the residential address, and telephone number, date of birth, sex and civil status of either parent or both parents as well as their social insurance numbers and health insurance numbers if available;

(11)  a signed and dated statement from the person or the person’s representative attesting that all the information provided is accurate.

O.C. 1470-92, s. 14; O.C. 505-96, s. 6; O.C. 552-2001, s. 9.