Change of Sex Designation

Manitoba Health, Seniors and Long-Term Care

Change of sex designation

Change of sex designation
Supporting documentation

Cardholder's information

Registration number (six-digit alphanumeric)

*

Personal Health Identification Number (PHIN - nine digits)

*

Primary phone number

*

Email address

*

Can we contact you at this email address?

Legal first name

*

Legal middle name

*

Legal last name

*

Please select one

Specify your sex

*

Date of birth

*

Select either English or French as your official language

Current address

Apartment/unit number

*

Street address (or PO box number)

*

City

*

Province

Postal code

*

Is your mailing address the same as your current address?

Mailing address

Apartment/unit number

*

Street address (or PO box number)

*

City

*

Province

Postal code

*

Change of sex designation

I would like to change my sex designation to

Specify the sex you would like to change to

*

Will you require a change of name?

Change of name (How your new legal name(s) should appear on the Manitoba Health Card)

Legal first name

*

Legal middle name

*

Legal last name

*

Type of card

Select the type of card

Generate a new image Play the audio code

Enter the code from the image