Get Notification Of Extended Absence Form - Ehealth Saskatchewan

Filling out the Notification Of Extended Absence Form is essential for Saskatchewan residents planning to be away from the province for six months or more or returning from such an absence. This guide provides clear, step-by-step instructions to help users complete this form efficiently and accurately online.

Follow the steps to complete the Notification Of Extended Absence Form online

1. Click ‘Get Form’ button to obtain the Notification Of Extended Absence Form and open it for editing.
2. Complete Section A: Requester Personal Information by entering your health card number, mailing address, last name, first name, middle name, birth date, and sex. Ensure that at least one phone number is provided.
3. In Section A, indicate whether you will be absent for six months or more by selecting 'Yes' or 'No'. If 'Yes', provide the expected date of absence and the reason for your absence.
4. If you are returning to Saskatchewan, fill out your return date in the appropriate fields of Section A.
5. Complete Section B: Spouse/Partner Personal Information if applicable. Enter their health card number, contact details, and confirm their absence status as outlined in the form.
6. In Section C: Dependant Personal Information, list the information for your dependants, if applicable. Fill out their health card numbers, names, birth dates, sex, absence status, and reasons for absence.
7. In Section D: Declarations, both the requester and spouse/partner must sign and date the declaration, certifying the accuracy of the information provided.
8. Review the completed form to ensure all required information is filled out correctly. Attach any necessary documents, like proof of full-time enrollment for students.
9. Once completed, save your changes, and you can choose to download, print, or share the completed form as necessary.

Complete the Notification Of Extended Absence Form online today to ensure your health coverage remains intact while you are away.