Designated incurable disease Supporter Certification Project (Registrant ID)

It is a proof issued by the City of Yokohama to those who have applied for it so that patients in the designated incurable disease can smoothly use measures for independent daily support in the community by certifying the facts of the designated incurable disease.
In principle, it is linked to your My Number Card and you can check the contents on the minor portal, but you can also issue it on paper to those who wish.
In addition, since the expiration date is not set, those who have been issued a registrant's card once can continue to use it after the expiration date. (There is no application for renewal.)

・Those who have resident certificate in Yokohama City

・Those who meet the diagnostic criteria of the designated incurable disease

※If you wish to receive a registrant ID, you will need to apply for a new registrant ID. Please note that it will not be automatically issued to those who do not apply for a new registration card or who have only applied for a specific medical expenses (designated incurable disease) grant program.

●Name

●Date of birth

●Effective date

※The name of the disease will not be displayed on the registration card.
Please note that if you need to show the name of the disease when using the service, you will not be able to use the registrant's card as proof.

Please submit the following documents.

・Registration card (designated incurable disease) application form (first style): You can download it from the following. (Please be sure to read the attached sheet.)
　Registration card (designated incurable disease) application form (first style) (Excel: 50KB)
　Registration card (designated incurable disease) application form (first style) (PDF: 142KB)
　・・・ Please check "New Application" in the check box at the top of the application form.
　Attachment (PDF: 285KB)

・Identification of recipient of specific medical expenses (designated incurable disease) or clinical survey personal card (medical certificate)
　・・・ Clinical survey personal form can be downloaded from the following website.
　http://www.nanbyou.or.jp/ (outside site) (outside site) (link: incurable disease Information Center)
　 http://www.mhlw.go.jp/stf/seisakunitsuite/bunya/00000084783.html (external site) (link: Ministry of Health, Labour and Welfare website)

・Personal number report (No. 4 style) pertaining to the registrant's card ... You can download it from the following.
　※Confirmation documents will vary depending on the applicant. Personal Number Declaration Form (No. 4 Form)
　　After confirming the second page of “About required documents” (PDF: 225KB), copy it in the case of mail application.
　　Please enclose it and mail it. When applying for a window opening, please bring the required documents as the original will be checked at the window opening.

　Personal number report (No. 4 style) pertaining to registrant ID (Excel: 30KB)
　Personal number report (No. 4 style) pertaining to registrant ID (PDF: 269KB)
　Power of Attorney (Excel: 10KB)
　Power of Attorney (PDF: 37KB)

●Only incurable disease designated physicians can create a personal card for clinical research in required documents.
For a list of incurable disease designated doctors designated by Yokohama City, please refer to the designated doctors and designated medical institutions.

If you change the name on the registrant's card of the paper issued by Yokohama City, you will need to submit an application for the change.
(For information on changing the name on the registrant's card issued from another city, please contact the local government of the grantee.)

・Registration card (designated incurable disease) application form (first style): You can download it from the following. (The same as the new application form.)
　Registration card (designated incurable disease) application form (first style) (Excel: 50KB)
　Registration card (designated incurable disease) application form (first style) (PDF: 142KB)
　・・・ Please check "Application for Change" in the check box at the top of the application form.
　・・・ Please enter the name after the change in the part where "If you are applying for a change, please also fill in this form."

・(If you have already been transferred out of the city) A public certificate that allows you to confirm your name before and after the change
　※If you have a resident certificate in Yokohama, you do not need a certificate.

If the registrant's card of the paper issued by Yokohama City is lost, damaged or damaged, you can apply for a reissue.
(For reissuance of registrant ID issued from other cities, please contact the local government of the grant source.)

　Registration card (designated incurable disease) application form (first style): You can download it from the following. (The same as the new application form.)
　Registration card (designated incurable disease) application form (first style) (Excel: 50KB)
　Registration card (designated incurable disease) application form (first style) (PDF: 142KB)
　・・・ Please check "Re-issue" for the check box at the top of the application form.

If you return your registrant's card due to healing or death, you can return the registrant's card.

・Registration card (designated incurable disease) application form (first style): You can download it from the following. (The same as the new application form.)
　Registration card (designated incurable disease) application form (first style) (Excel: 50KB)
　Registration card (designated incurable disease) application form (first style) (PDF: 142KB)
　・・・ Please check "Return Application" in the check box at the top of the application form.

・Registration Card

The support and services that can use the registration card are as follows.

• Application for receiving disability welfare services
• Employment counseling and employment placement in Public Employment Security Office (Hello Work)

Depending on the support / service, there are requirements other than the registrant's card to receive support / service.
You may be required to submit additional documents other than your registration card.
※In the future, there may be more support and services that can use registrant IDs.

〒231-0062
56 Minato Mirai 21 Clean Center at 1-1 Sakuragicho, Naka-ku, Yokohama City
City of Yokohama, Health and Social Welfare Bureau Medical Aid Division, incurable disease
※It is also possible for family members to fill out the form on behalf of them.
※If there are any omissions or shortages in the submitted documents even if you apply at the ward office Elderly and Disabled Support Division window, please be aware that the Health and Social Welfare Bureau Medical Aid Division incurable disease will contact you.
　

Health and Welfare Centers Elderly and Disabled Support Division
※It is also possible for family members to apply on their behalf.
※If there are any omissions or shortages in the submitted documents even if you apply at the ward office Elderly and Disabled Support Division window, please be aware that the Health and Social Welfare Bureau Medical Aid Division incurable disease will contact you.