Electronic Forms

The forms right below are electronic forms that you can fill out right now on-line and submit with the click of a button. No need to print them, mail them or deliver them otherwise. You can do everything from the comfort of your home right now. The Change of Address Form can only be done electronically. The other forms can be done electronically or on paper, but please do not do both.

Change of Address Form

Enrollment Form

HIPAA Authorization

Family Supplemental Benefits Form

Other Insurance Form

Subrogation Form

Transfer Request - Pension

Transfer Request - Welfare

Pension Direct Deposit Form

Prescription Refill Form   (from the Caremark website - fill out the form online, print it and mail it in)

Paper Forms

The forms below are paper forms that you can printout and mail in to the office or deliver them in person. Click on the form you need to view it and print it. You will need
Adobe Reader to do this. If you do not have Adobe Reader click here to download it.