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Form 4436

Form used to confirm the place of residence of a person or family. Must be signed before a commissioner for oaths. The form remains valid for 45 days.

Form 4249

The Visual Devices Program is intended for persons covered by the Québec Health Insurance Plan who have a visual impairment. These persons may have low vision or may be functionally blind. 

This form confirms the intention of the parent or legal guardian of a child to reside in Québec for a period of more than 6 months following the date of registration of the child for health insurance. It must be signed before a commissioner for oaths and remains valid for 45 days.

Form 4489

The following form is intended for persons wishing to obtain information on the services covered by RAMQ that they have received.

Form 3407

The Program for Devices That Compensate for a Physical Deficiency is intended for persons covered by the Québec Health Insurance Plan who have a motor deficiency. 

To find out more, refer to the page Devices that compensate for a physical deficiency.