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

This is a fax form for advance application. Please be careful not to fax your personal information.

Please bring it with the original "Information Provision Application Form (FAX Advance Application)" at the time of receipt.
※You will also need your ID card.
※Be sure to print on both sides.

Please refer to the following for details regarding the provision of information and the applicant confirmation documents.

• Click here for more details (to City of Yokohama, Health and Social Welfare Bureau page).