1 Your identity
2 vos coordonnées au Québec
3 Renseignements sur votre situation
4 Votre séjour au Québec
5 Précisions sur votre séjour au Québec
6 Next
7 Fin

Register for health insurance for a temporary stay: Adult

Unless otherwise indicated, you must answer all questions.

Your identity

First name

For multiple first names, please indicate the most commonly used.

Name of spouse (optional)

You can have your spouse’s name added to your Health Insurance Card if you married in Québec before April 2, 1981. It is also possible if you married outside Québec and legally exercise your civil rights under your spouse’s name.

Last name at birth

Date of birth

Example: Thirty-one, then slash, then zero one, then slash, then two thousand, five

Sex

Female

Male

Social insurance number in Canada (optional)

Example: Three nines, followed by three nines, followed by three nines

app.This person has a Québec Health Insurance CardThis person does not have a Québec Health Insurance Card