Member Resources
Current Member Handbook
Forms
- Authorization to Use / Disclose PHI Form (PDF)
- Authorization to Use / Disclose PHI Form - Spanish (PDF)
- Revocation of Authorization to Use / Disclose PHI Form (PDF)
- Revocation of Authorization to Use / Disclose PHI Form - Spanish (PDF)
- Appeal Form (PDF)
- PCP Change Form - English (PDF)
- PCP Change Form - Spanish (PDF)
- Health Risk Screening Form (PDF)
Helpful Links
- Healthy Children website by American Academy of Pediatrics
- Baby Center website
- March of Dimes website
- The Hotline website by National Domestic Violence Hotline
- The CDC's webpage on Diabetes
- The CDC website
- My Plate website by the U.S. Department of Agriculture
- My Health Finder website by the U.S. Department of Health and Human Services
- Lung website by American Lung Association
- Your Disease Risk webpage by Siteman Cancer Center and Washington University
- Cancer website by American Cancer Society
- AARP website
- Mental Health Resources webpage by the U.S. Veterans Affairs
- Breast Cancer Resources webpage by Susan G. Komen
- Kids Health website by Nemours Children's Health
- Nutrition website by U.S. Department of Agriculture
- Eat Right website by Academy of Nutrition and Dietetics
- Sickle Cell Disease Educational Repository website by Sickle Cell Disease Association of America
- Sickle Cell Disease website by Sickle Cell Disease Association of America
Approval Date: 11/4/2014
Approval Code: HSHP14075