Navigating a request for medical assistance in dying in Northwest Territories

Local MAID Forms | February 11, 2022

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Navigating a request for medical assistance in dying in the Northwest Territories

To begin the process of requesting medical assistance in dying (MAID), it is recommended that you speak with your health care provider or local MAID coordination service. Alternatively, you can contact Dying With Dignity Canada’s Support team at support@dyingwithdignity.ca or 1-844-395-3640. We can answer general questions about MAID or provide navigation support. 

The following information can help you navigate a request for medical assistance in dying in the Northwest Territories. 

Northwest Territories’ forms for medical assistance in dying

Download the Formal Written Request by Patient form for the Northwest Territories.  


NWT Central Coordinating Services

Phone: 855-846-9601
Toll free: 867-767-9050 x 49008
Available Monday to Friday from 8:30 a.m. to 5:00 p.m. Mountain Time

More information

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