Application for the Interim Federal Health Program (IFHP) Coverage (IMM 5564)
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Application for the Interim Federal Health Program (IFHP) Coverage [IMM 5564] (PDF, 1.0 MB)
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Application for IFHP Coverage (IMM 5564)
Section A - Personal Details
In this section, write your personal information, such as family name, date of birth, address, etc.
Note: You can find your client identification number (Client ID) on your immigration document, issued by the IRCC office, the Case Processing Centre, or the visa office where you filed your claim.
Section B – Information for Document Replacement
Fill out only if your IFHP document was lost, stolen or destroyed and you are asking for a confirmation of existing IFHP coverage.
Section C – Your Status in Canada
In this section, describe your immigration status in Canada. Your answers in this section will be used to decide if you are eligible for IFHP. Answer truthfully and to the best of your knowledge.
Section D – Other Information
In this section, tell us if you are eligible for or receive coverage under any provincial or territorial health insurance plan. Your answers in this section will be used to decide if you are eligible for IFHP. Answer truthfully and to the best of your knowledge.
Section E – Declaration of Applicant
Read the declaration. Then sign and date at the bottom of the form.
Make sure you attach the supporting documents listed in Step 1: Gather documents.