Your needs are our top priority
Keeping you healthy is important to us. Here you will find information to help you understand your plan. We want to help you manage your health and improve your care.
Authorization to share information
Protected Health Information (PHI) means information about your health. Federal and state laws protect the privacy of your PHI. We will only give out the PHI that you say we can share. And, we will only give it to the people or agencies that you list. Use the forms below to give us your OK to share your information.
- Authorization to Release Protected Health Information (PHI) Form
- Authorization to Release Psychotherapy Notes Form
- Protected Health Information (PHI) Access Request
- Request for an Accounting of Disclosures of Protected Health Information (PHI)
- Removal of Authorization Previously Given to Aetna