Documents Center
Important: These forms are for Capital Health Plan members and enrolled employer groups only. Electronic submissions will not be accepted. Members must submit signed forms to their Personnel Office for processing.
- CHP Case Management Program
- Enrollment Form 96.9 KB (PDF)
- Member Status Change Request Form 108.3 KB (PDF)
- Communications Directive Form 21.8 KB (PDF)
- Authorization to Disclose Protected Health Information Form 66.9 KB (PDF)
- Immunization Charts
- Children's Check-ups
- Preventive Screening Charts
- Preferred Medication List
- Tips for Better Laboratory Services 265.9 KB (PDF)
- Important Information about Your Plan
- Living Wills and Other Advance Directives
- Dependent Eligibility Verification Form
Documents on this page are available in Adobe Acrobat Portable Format (PDF). Click here to download this free software from Adobe.