Authorized Representative
For naming a person who may speak for a Health First Colorado member, with signatures.
Secure form coming soon. Call us.
This form can include health information, a Medicaid ID, or a signature, so it is not sent through this website. Please call (720) 595-4418 or email care@sunshinehcss.com and we will help you complete it another way.
Draft for owner and legal review
The owner still needs to build this form in a HIPAA-ready tool and set HIPAA_FORM_AUTHORIZED_REPRESENTATIVE_URL. The field list is in FORMS.md. After the URL is set, redeploy so the security policy allows that form host.