Legal Decision Maker and Shared Custody Arrangement
This form allows you to add someone who is legally authorized to act on your behalf. This includes a power of attorney, substitute decision maker, committeeship, or someone with a shared custody arrangement.
1.
Gather one of the following documents
Power of attorney
Complete signed power of attorney document
Substitute decision maker
Complete signed Substitute decision maker document
Committeeship
Complete signed Order of Committeeship document
Shared custody arrangement
- Child's birth certificate showing the names of both parents
- Joint/shared custody agreement
- A document that shows you have permission to make decisions for this child (for example, a care agreement, or a signed letter from an Indigenous Service Provider or Provincial Child and Family Services)
2.
Complete the form
Before starting the online form:
This form will not automatically send out a health Card.
You will receive an email confirming that your request has been approved and that you may now request a health card for that individual, if required.
Individuals that hold a Power of attorney, Substitute decision maker or Committeeship may request a plastic health card.
Individuals that have a shared custody arrangement may request a plastic health card or a digital health card or both.
When you are ready, complete the following form:
Legal Decision Maker Form
Shared Custody Arrangement Form
Need help?
Public Access Computers are available at the following locations:
Winnipeg
Bilingual Service Centre
Main floor, 170 Goulet St, Winnipeg MB
Rural areas
Contact the city or municipal office in your area, or visit the Bilingual Service Centre nearest you:
51 Rogers St, Notre-Dame-de-Lourdes MB
Unit A, 30 Dawson Rd, Ste Anne MB
Recreational Centre on Hwy 6, St. Laurent MB
427 Sabourin St, St-Pierre-Jolys MB
