Skip to content
OhioHealthy
Members
Providers
Employers
Contact Us
Sign In / Register
Sign In / Register
MENU
Manage My Plan
Frequently Asked Questions
Find Doctors and Locations
Home
Members
Manage My Plan
Forms
Forms
Alternate Addresses
Alternate Address Form
Authorizations for Release of Medical Information
Designated Representative Authorization Form
Authorization for Use or Disclosure of Medical Information (Designated Agent)
Authorization To Release & Obtain Protected Health Information (PHI)
Authorization for Use or Disclosure of Substance Use Disorder Services Information
Revocation of Authorization Form
Eligibility
Adult Incapacitated Dependent Certification Form (OhioHealth)
Complaints and Member Appeals
Member Appeals Packet
Member Complaints Packet
Got a spare 10 minutes to help us improve our website?
I'll do it
No thanks
Manage My Plan
Forms
Appeals Process
Covered Preventive Services
Maximum Out of Pocket Information
Member Rights and Responsibilities
Coronavirus Assessment Tool
Close
