List of Disability Welfare Application Forms
For those applying for Disability Welfare services for the first time or those updating the validity period of the services, submission of necessary documents is required.
Regarding the service utilization plan draft, there is a "service utilization plan" created by the local planning consultation support office and a "self-plan" service utilization plan draft created by the individual. Please submit one of them.
If you have any questions about the procedures, please contact the Disability Welfare Division.
List of Documents for Users
Documents required for new service applications, renewals, etc.
In the case of renewal, we will send the necessary documents one month before the expiration date of the recipient certificate.
- Application Form for Nursing Care Benefits and Training Benefits (PDF 272.8KB)
- Application Form for Care Benefits and Training Benefits (Word 109.0KB)
- Application Form for Care Benefits and Training Benefits (Sample) (PDF 413.6KB)
If you have created your own usage plan, please submit it.
Documents required for changes in benefits, services, etc.
- Application Form for Nursing Care Benefits and Training Benefits (PDF 272.8KB)
- Application Form for Care Benefits and Training Benefits (Word 109.0KB)
- Application Form for Care Benefits and Training Benefits (Sample) (PDF 413.6KB)
If you have created your own usage plan, please submit it.
Documents required for changes to name, address, etc.
- Application Form for Change of Application Details (PDF 93.0KB)
- Application Form for Change of Application Details (Word 50.5KB)
Documents Required for Reissuance of Recipient Certificate
- Application Form for Reissuance of Beneficiary Certificate (PDF 95.8KB)
- Application Form for Reissuance of Beneficiary Certificate (Word 49.5KB)
Other Topics
- Request for Consultation Support Plan (Change) Notification (PDF 76.0KB)
- Request for Planning Consultation Support (Change) Notification (Word 38.5KB)
- User Burden Limit Management Office Request Form (PDF 31.3KB)
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Inquiries about this page
Inagi City Welfare Department Disability Welfare Division
2111 Higashi-Naganuma, Inagi City, Tokyo 206-8601
Phone number: 042-378-2111 Fax number: 042-378-5677
Contact the Disability Welfare Division, Welfare Department of Inagi City