Submitting Your Personal and Medical Information as the Recipient of a Social Assistance Program

You must notify the Ministère de l’Emploi et de la Solidarité sociale when there is a change in your medical situation. This change could affect the amount of your benefit or your eligibility for financial assistance. 

To authorize the Ministère de l’Emploi et de la Solidarité sociale to disclose your personal information to another party, you must provide written authorization to the Ministère.

You will have to complete this form:

If you want to designate someone to act on your behalf, please go to Authorizing someone else to act on your behalf as the recipient of a social assistance program.

The Curateur public’s assistance measure allows you to have one or two assistants of your choice recognized. This measure is for adults living with difficulties who wish to be supported by a loved one in making decisions and managing their assets.

Once recognized, each assistant will be listed in a public register. They will be able to act as an intermediary for the assisted person when dealing with agencies, government departments and service providers.

They will be able to communicate and receive information, but not to act on behalf of the assisted person.

Learn more about the Curateur public’s assistance measure.

Medical certificate

The medical certificate (French only) (PDF 227 Kb) is for service providers and is used to:

• Certify a pregnancy
• Certify a medical need that may lead to a request for special benefits
• Confirm the need for medical transport

The medical certificate must be completed by the relevant healthcare professional:

• Physician
• Specialized nurse practitioner (SNP)
• Dentist
• Midwife

Medical or Psychosocial Assessment Report

You may submit a medical or psychosocial assessment report demonstrating that your physical or mental condition prevents you from working. The work interruption must last at least one month.

Your healthcare professional will have to complete the Medical or Psychosocial Assessment Report (SR-2100A) form (PDF 59 Kb).

Notice of admission to or discharge from a healthcare institution

In some cases, a social assistance program recipient may have to be admitted to or discharged from a facility recognized by the Ministère de la Santé et des Services sociaux.

When this happens, a healthcare professional or healthcare agency must notify the Ministère de la Santé et des Services sociaux by submitting this form (in French only):

You can submit documents:

• In person or by mail to your Services Québec office
• Online using My Account – Employment Assistance – Social Assistance.

Submit documents