Health Plan

Santa Clara County, CA

Official Website: http://scfhp.com

Forms & Documents

Browse all Health Plan government forms

41 - 60 of 106 forms

Form Title Topics
Long-Term Care Authorization Form FAQs
Long-Term Care Discharge Notification Form
LTSS Training Attestation
Medi-Cal/Healthy Kids Member Grievance Form (
Medi-Cal/Healthy Kids Member Grievance Form (English
Medi-Cal/Healthy Kids Member Grievance Form (Espanol
Medi-Cal/Healthy Kids Member Grievance Form (Tagalog
Medi-Cal/Healthy Kids Member Grievance Form (Ting Vit
Medi-Cal Preventable Conditions Reporting Form
Medical Records Review Survey
Pediatric Questions by Age Group
Primary Care Facility Identification Form
Prior Authorization Request - Medical Services
Prior Authorization Request - Prescription Drug
Provider Dispute Form
Provider Dispute Form - Multiple "Like" Claims
Requirements for the Staying Healthy Assessment
Staying Healthy Assessment - 0-6 Months (
Staying Healthy Assessment - 0-6 Months (English
Staying Healthy Assessment - 0-6 Months (Espanol

Contact Information & Office Locations

1 contact point

Main Office

Address:
6201 San Ignacio Ave.
San Jose, CA 95119

Phone numbers:
  • (408) 376-2000

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