Forms & Resources

At HPI, we take our commitment to your health very seriously. That’s why we want to be a key source of tools and information to help you be the healthiest you you can be.

Would you like to:

Print a form?

Order an ID Card?

Forms for Members

 Authorizations & Verifications

 Online Access / PHI Disclosure Form

 Member Authorization to Obtain PHI

 Member Authorization to Release PHI - Care Management Services

Member Authorization to Release PHI - Claims

 Transition of Care Request Form

Member Appeal

 Member Appeal Form 

Member Reimbursements

 Fitness Reimbursement Form

 Member Reimbursement Form

 Travel Reimbursement Form

Pre-Certification Guidelines

 Pre-Certification Guidelines