Health Plan

Santa Clara County, CA

Official Website: http://scfhp.com

Forms & Documents

Browse all Health Plan government forms

21 - 40 of 106 forms

Form Title Topics
Bed Hold Authorization Request Form
Behavioral Risk Topics - At-A-Glance
Cal MediConnect List of Covered Drugs (Formulary
Cal MediConnect Part D Coverage Determination Request
Case Management Referral Form
CCS/GHPP Discharge Planning Service Authorization Request
Change Notification Form
Compliance Guide: First Tier, Downstream and Related Entities
Coordinated Care Initiative - Frequently Asked Questions (FAQs) for Providers
DME Order Form
DME Specialty Device List
Early Start Referral Form
First Tier, Downstream and Related Entities Training Attestation
General Authorization for Release of Medical Records
Health Education Referral Form (English
Instruction Sheet for Providers
Letter of Interest - PCP
Letter of Interest - Specialist & Ancillary
Long-Term Care Authorization Form
Long-Term Care Authorization Form FAQs

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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