Navigating a request for medical assistance in dying in Northwest Territories
Local MAID Forms | February 11, 2022

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