At Health Plus, our mission is to work to ensure that every child and adult in New York City and Nassau County has access to free and low cost healthcare.
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  1. 9th Annual Asthma School Poster Contest
  2. Little League Champs Pose with Yankees Star A-Rod
  3. Health Plus Implements Paperless Applications
  4. Boroughs, City and State Declare: “Today is Health Plus Day”
  5. Teen Health
  6. Message from Executive Director
  7. Time To Renew Your Health Insurance?
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Home > Referral Information and Forms
 

Referral Information and Forms

  • Health Plus Referral Form (for CHP, FHP and Medicaid members only) - ( PDF, 50KB)
  • Health Plus DM/CM Referral Form for disease or case management services - ( PDF, 110KB)
  • How to Refer a Member for Specialty Care (CHP, FHP and Medicaid only) - ( PDF, 81.4KB)
  • W-9 Form and Instructions - ( PDF, 326KB)
  • Health Plus Elite (Medicare) Referral Form - ( PDF, 40KB)
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Child Health Plus Family Health Plus Medicaid Medicare
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