Forms for Download
Centene Pharmacy Services understands that you and your family lead a busy life, and we want to make sure that the forms and resources you need are easily accessible to you, day or night. Please find below the most commonly-used forms that our members request. If you do not see a form you need, or if you have a question, please contact our Customer Service Center 24 hours a day, 7 days a week, 365 days a year at (800) 460-8988.
- Authorization to Disclose Health Information - English (PDF)
- Authorization to Disclose Health Information - Spanish (PDF) - or Autorizacion para Divulgar Informacion Medica
- Revocation of Authorization to Disclose Health Information - English (PDF)
- Revocation of Authorization to Disclose Health Information Form - Spanish (PDF) - or Revocacion de la Autorizacion para Divulgar Informacion Medica