Frequently used health care forms
Download and print the health plan form you need.
- Authorization for the Release of Protected Health Information
- Coordination of Benefits Form
- Applied Behavioral Analysis (ABA) Authorization Form
- Nevada Claim Form
- Primary Care Physician Change Request Form
- Pharmacy Reimbursement Claim Form
- Substance Abuse Records Release Form
- New Prescription Fax Order Form
- Medical Necessity Request Form
If you don't see the form you're looking for, please call the Member Services number on the back of your health plan ID card.