Frequently Requested Forms

Medical Record Access, Changes,
and Health Care Information Release

How to Transfer and Get Copies of Your Medical Records

Parental Access

First, you need access to your own online record. Print and fill out form, take to any Group Health Medical Center, and show your photo ID. Fill out a form for each child, 12 and younger.

Transfer of Funds for Medicare Premium Payment

Enrollment and Change Forms

Pharmacy Forms

Claim Forms

Medical and Pharmacy Reimbursement Claims

How to Submit Claims for Reimbursement

    Applied Behavioral Analysis (ABA)

    Specialty Visit Questionnaires

    You may be asked to fill out a questionnaire before an appointment with a specialist.

    Well-Care Questionnaires

    These questionnaires are to be filled out before a well-care visit, also called preventive care.

    Informed Consent Forms

    * To protect the security of personal information, you must log in to MyGroupHealth for Members to use these online forms. This helps us process your request more quickly. (To log in, you have to be registered.)

    If you don't want to log in, in some cases, there is also a PDF version of the same form. However, you must print the PDF, fill it out, and send it via postal mail. For security reasons, PDFs cannot be submitted as e-mail attachments.

    ** You can refill and transfer prescriptions online by logging in to MyGroupHealth for Members. (To log in, you have to be registered.)

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