Access common forms and information that Colorado HealthOP members need from this central location. Additional forms and member information are available on the Member Portal.

If you are looking for another form, please contact Member Services toll-free at 866-915-6619, Mon – Fri, 8 am –  10 pm; Saturday 8am – 4pm Mountain time.

Common Forms & Information

Affidavit of Domestic Partnership
Colorado HeatlhOP Transition of Care Form
Health Actions Information
Health Actions Credit Form
Health Incentive Account – List of Eligible and Ineligible Expenses
HIPAA Authorization Form
Notice of Privacy Practices
Pharmacy Info
Pre-Authorization Pre-Certification Sheet
Privacy Notice Gramm Leach Bliley
Member Status Info Change Form
Provider Networks–EPO & PPO Network Information
Summary of Limitations and Exclusions

 

Health Screenings

Get a list of free preventive services for children adults available on all Colorado HealthOP plans. Preventive care services are covered only when you receive it from an in-network healthcare professional. Download Screening List