Health Forms

The following forms are here for your convenience.
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Click here for Flex Claim Forms

Health Enrollment Forms

• HealthEquity HSA Authorization Form
• Health Enrollment Form
• Request for Change Form
• Alternate Payee Request Form
• Dependent Disability Form
• Common Law Affidavit
• Change of Address

Health Claim Forms

• Accident Questionnaire
• Authorization to Release Confidential Health Claim Info
• C.O.B. Questionnaire
• Disability Application
• Domestic/International Claim Form