Health Plan

Santa Clara County, CA

Official Website: http://scfhp.com

Forms & Documents

Browse all Health Plan government forms

1 - 20 of 106 forms

Form Title Topics
2019 Medical Benefit Drug Prior Authorization Grid
2019 Medical Covered Services Prior Authorization Grid
Access to Care Training Attestation
Accommodation Check Sheet for Seniors and People with Disabilities
Adult Questions by Age Group
Advance Health Care Directive Form - Chinese
Advance Health Care Directive Form - English
Advance Health Care Directive Form - Spanish
Advance Health Care Directive Form - Tagalog
Advance Health Care Directive Form - Vietnamese
Alternative Staying Health Assessment Tool Request Form
Authorization for Release of Genetic Test Results
Authorization for Release of HIV/AIDS Test Results
Authorization for Release of Mental Health and/or Substance Abuse Records
Authorized Representative Form
Authorized Representative Form (
Authorized Representative Form (Espanol
Authorized Representative Form (Tagalog
Authorized Representative Form (Ting Vit
Become a California Children's Services Provider

Contact Information & Office Locations

1 contact point

Main Office

Address:
6201 San Ignacio Ave.
San Jose, CA 95119

Phone numbers:
  • (408) 376-2000

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