Member Forms

Below is a list of forms that are in Adobe Acrobat Icon Adobe® Portable Document Format (PDF) for your convenience. The PDF (Portable Document Format) will preserve the look and feel of the original document, including the colors, images and formatting. If you do not have the Acrobat Reader—or aren't sure—get the free Acrobat Reader now. If there are any questions please don't hesitate to ask NHP!

POS Claim Form

Authorization for Use and Disclosure of Protected Health Information (English)

Authorization for Use and Disclosure of Protected Health Information (Spanish)

Grievance Form (English)

Grievance Form (Spanish)

Appointment of Representation

Member's Rights & Responsibilities

Member Handbook

Member Handbook Second Amendment

Member Handbook Third Amendment

Member Handbook Fourth Amendment

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Resources

FAQs
Frequently Asked Questions

Pharmacy Online
Pharmacy and Health information services

United Behavioral Health (UBH)
Your mental health is just as important as your physical health.

Neighborhood Additions Program
Special resources for pregnant members

DOC Talk
Checklist you may use at your next doctor's visit.

Links

FloridaHealth-
Stat.com
Find HMO Performance outcomes and Financial Info

Labcorp Inc. Find the Patient Service Center most convenient for you

Cancer Page, Your Cancer Community Online A trusted source for the latest news, research, and information on prevention, detection, and treatment.