SCIS Card Applications Forms (Current Members)

Secure Certificate of Indian Status *Added July 12, 2018
Registration-SCIS Guarantor Declaration

Indian Registration Administration (New Registrations)

Adult Registration-SCIS Application
Child (15 and Under) Registration-SCIS Application
Instruction Booklet for Adult Registration-SCIS Application
Registration-SCIS Guarantor Declaration

If you have any trouble completing these forms, please contact the Indian Registration Administrator, Nancy O’Connell, at 709-634-4010 or 1-855-263-6440 (toll free in Newfoundland only).  You may also email Nancy at noconnell@qalipu.ca

Non-Insured Health Benefits Forms

List of Approved Mental Health Providers (PDF)
Health Canada Client Reimbursement Form
(PDF) *Updated July 17, 2020
Qalipu Medical Transportation Reimbursement Form (PDF) *Added December 15, 2017
Qalipu Medical Transportation Reimbursement Form Guideline (PDF) *Added December 15, 2017
Benefit Exception Request Form
(PDF) *Updated September 4, 2018
Client EFT Direct Deposit Form (PDF) *Updated November 2, 2018
Vendor EFT Direct Deposit Form (PDF) *Added November 2, 2018