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Forms and resources

Below are forms and resources for members. If you have questions about this information, call member services at 612-596-1036.


Appeals and grievances

  • Member appeals and grievances form (PDF)
    Download

Service authorizations

  • Patient authorization form for release of information (PDF)
    Download

Transportation verification form

  • Transportation verification form (DOCX)
    Download

Products

  • Hennepin Health-PMAP
  • Hennepin Health-MNCare
  • Hennepin Health-SNBC

Get a ride to medical visits

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Get a ride

Replace your ID card

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ID card replacement
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