Confidential Communications Request

Use this form only if you want CalViva Health to send your health-related mail and documents to a different, private mailing address instead of your usual home address. This is the right form if you want to keep your medical information confidential from other people who live with you—for example, if you want your appointment notices or treatment letters sent securely to a P.O. Box or a trusted friend’s address.(Note: This form does not give someone else permission to speak for you on the phone; it only changes where your mail is sent.)

Click here to be taken to the Confidential Communications Request Form

Authorization to Disclose Protected Health Information (PHI)

Use this form if you want to give CalViva Health permission to share your personal health information with a specific person or organization of your choice. This is the form you need if you want a trusted family member—such as a spouse, parent, or adult child—to be able to call Member Services on your behalf, help manage your healthcare, or discuss your benefits and claims with a representative.

Click here to be taken to the Authorization to Request PHI Form