Forms, Downloads & Links

Download & Links

• 1095-B FAQ

  PHP will NOT be mailing individual policyholder Form 1095-B for 2019. Click to learn more.

• Authorization for Use and Disclosure of Protected Health Information

  Specify who can receive your health information and exactly what information that they can receive with this simple form.

• Be a Flu Fighter
• Centers for Medicare & Medicaid Services

  These links will direct you to government-based Web sites that include detailed information on HIPAA and related healthcare issues.

• Coordination of Benefits Request Form
• Medical Dictionary

  Medical jargon can be difficult to understand if you're not around it all the time. This medical dictionary can help you understand frequently used terms, different kinds of tests, and more.

• Medical Treatment Consent Form

  Leaving your child with a babysitter or family member may mean they won't receive care without your consent. This will ensure that in an emergency, your child will receive prompt, necessary medical care even if you are not there.

• Student Coverage Form
• Symptom Checker

  Know your symptoms? Check out what they might mean with this helpful tool. As always, be sure to consult your family doctor if symptoms get worse.

• United States Department of Health & Human Services

  These links will direct you to government-based Web sites that include detailed information on HIPAA and related healthcare issues.