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• Appeal Form
• Application and change request - Individual (2018) Clark County
• Application and change request - Individual 2019
• Authorization to Disclose Protected Health Information
• Authorization to Disclose Protected Health Information (Spanish)
• Confidential Communication request form
• Electronic Funds Transfer form for Individual-Family plans - Clark County
• Incident Report
• Incident Report (Spanish)
• Member Reimbursement Claim Form
• Plan change request (individual) 2017
• Plan change request - Individual
• Preventive Health Care Coverage - Clark county (PDF) 2019
• Preventive Health Care Coverage - Clark county, WA - Spanish (PDF) 2019