The Long-term Care Insurance Application Documents (for business operators)

Last update date August 16, 2021

Please download various application documents necessary for nursing care (support required) certification from the following.
We also accept applications by mail. However, please note that the application date for various documents will be the date of receipt of the documents.

Destination

〒235-0016
3-5-1, Isogo, Isogo-ku, Yokohama-shi
Address to The Long-term Care Insurance, Elderly and Disabled Support Division, Isogo Ward Office

Phone: 045-750-2494 Fax: 045-750-2540

1 Application for nursing care (support required) certification

Download the form to the Yokohama City site (to the City of Yokohama, Health and Social Welfare Bureau page).
Fill out the required items and submit it along with your The Long-term Care Insurance insured card.
Precautions
Applications for renewal applications will be accepted 60 days before the expiration date of the certification validity period.

2 Home care service and care prevention care management plan creation request form

Download the form to the Yokohama City site (to the City of Yokohama, Health and Social Welfare Bureau page).
Please indicate your required items and submit it along with your The Long-term Care Insurance insured card.
The insured person's card will be returned by registered mail to the registered location of resident certificate on the next business day (or the destination set).

3 Information Provision Application Form

Download the form to the Yokohama City site (to the City of Yokohama, Health and Social Welfare Bureau page).
Please write required items on the application form and prepare the attached documents as necessary.
It will take approximately one week from application to provision. Thank you for your understanding.
※Please be sure to check the following notes before applying.

required documents for information provision

A. Information Provision Application Form
I. Applicant Confirmation Documents
　　Identification documents (employee card, employee ID card, etc.) with a photo of the affiliation
　　A certificate of enrollment is required for identity verification documents without the name of the business establishment.
C. Contract-related documents
　　We can omit when report of home, care prevention service plan making has been made beforehand.
　　For those who enter the facility, a copy of the contract is required. (Only the sealed part is acceptable.)

(a)　When you apply at the counter

We will check the applicant confirmation documents twice at the time of application and when the copy is issued.
Either must bring the confirmation documents of the applicant (applicant or representative on the front of the application).

(b)　When you apply by fax

There is a temporary application form for faxes. For more information, please contact us by phone.
When you receive the materials, please bring the original information application form and the applicant confirmation documents.

(c)　When you apply by mail

If you wish to receive a copy by mail, we will send it by registered mail.
In addition to the above required documents, please attach a return envelope (with stamp) and mail it.
The stamp fee is 404 yen for one person and 414 yen for 2 or 3 people.

Precautions

If you are using the home service, you will not be able to provide it unless there is a notification of the home care service plan creation request form. Please be sure to check before applying.
About contracted companies of prevention plan, please apply via Local Elderly Care Management Center in charge. (If you wish to apply directly, please contact us separately.)
Please return the provided materials as soon as the contract is terminated.