Procedures › Health insurance and pension
My wardsNHI eligibility change form for counter applications
Overview
Use this form to report joining or leaving National Health Insurance (NHI) in Itabashi Ward, or a change in NHI details. Submit it at the NHI and Pension Section counter or at a citizen office. The NHI and Pension Section counter has longer hours on Tuesdays and on the second Sunday of the month. The form is A4 size, portrait, and sample forms for joining and leaving are provided with it.
Form and when to file
- Form size: A4, portrait
- Use it to report joining NHI, leaving NHI, or a change in NHI details
Use the form for each person joining or leaving, and fill it in following the sample forms.
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Other guides in this topic
Health insurance and pensionJoining national health insuranceGuide Health insurance and pensionLeaving national health insuranceGuide Health insurance and pensionFuneral benefit for people under 75GuideHow to apply
- Fill in the NHI eligibility change form for joining or leaving.
- Submit it at the NHI and Pension Section counter or at a citizen office.
What to bring
- NHI eligibility change form (joining or leaving)
Where
Itabashi Ward Office
South Annex, 2nd floor, counter 22
- Weekdays 8:30–17:00 (not public holidays)
- Tuesdays until 19:00 at the NHI and Pension Section (not public holidays)
- Second Sunday of the month 9:00–17:00 at the NHI and Pension Section
Contact
NHI Eligibility Unit, National Health Insurance and Pension Section
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