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Home > For Members > Forms and Documents

Forms and Documents

This page includes important forms and documents to help you get the most out of your First Choice Next plan for now and whatever comes next.

Do you have a question or need help with a form? Call Member Services, Monday through Friday, 8 a.m. to 8 p.m., at 1-833-983-7272 (TTY 711).

  • Member Handbook (PDF)
  • Evidence of Coverage (PDF)
  • Authorization for Disclosure of Health Information (PDF)
  • Personal Representative Request Form (PDF)
  • Member Reimbursement Medical Claim Form (PDF)

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