Download and print a health care form.
- Authorization for the Release of Protected Health Information (PDF)
- Employee Enrollment and Change Form (PDF)
- Employee Enrollment and Change Form - Spanish (PDF)
- Employer Group Enrollment Form (PDF)
- Nevada Claim Form (PDF)
- Member PHI Release Authorization Form (PDF)
- Coordination of Benefits Form (PDF)
- Applied Behavioral Analysis (ABA) Authorization Form (PDF)
- ACA Individual Plan Member Change Form (PDF)
- Primary Care Physician Change Form (PDF)
- Pharmacy Reimbursement Claim Form (PDF)
- Substance Abuse Records Release Form (PDF)
- New Prescription Mail-in Order Form (PDF)
- New Prescription Fax Order Form (PDF)
- Medical Necessity Request Form (PDF)
If you don't find the form you’re looking for, contact your Group Services representative.