MSPApplicationforEnrolment-ProvinceofBritish介绍.PDF

MEDICAL SERVICES PLAN (MSP) APPLICATION FOR ENROLMENT PLEASE PRINT IN CAPITAL LETTERS ONLY 1 2 3 4 A B C D Before completing this application, please read IMPORTANT INFORMATION on page 2. Residents of BC are required, by law, to enrol themselves and to enrol their spouse and children who are residents of BC. RESIDENT means a person who is a citizen of Canada or is lawfully admitted to Canada for permanent residence, who makes his or her home in British Columbia, and is physically present in British Columbia for at least 6 months in a calendar year, or a shorter prescribed period, and includes a person who is deemed under the regulations to be a resident but does not include a tourist or visitor to British Columbia. 1 APPLICANT INFORMATION APPLICANT LEGAL LAST NAME APPLICANT LEGAL FIRST NAME APPLICANT LEGAL SECOND NAME BIRTHDATE (MM / DD/ YYYY) GENDER DAYTIME TELEPHONE NUMBER As a person must be a resident of BC to qualify for provincial health care benefits, M your current residential address is required.