Referral Information and Forms

  • Health Plus Referral Form for visits to participating specialists - (PDF, 40.7KB)
  • Health Plus DM/CM Referral Form for disease or case management services - (PDF, 110KB)
  • How to Refer a Member for Specialty Care - (PDF, 81.4KB)
  • W-9 Form and Instructions - (PDF, 326KB)
Note: To view documents in PDF format, you'll need Adobe Acrobat Reader. If you don't have it installed already, please click here to install.)

To save PDF file, right mouse click on link, select "Save Target As..." and choose location to save document.