Child Health Plus Member Forms

From payment authorization forms to income declaration forms and more, find complete resources for Child Health Plus. En Espanol.

• Download these helpful forms to manage your Child Health Plus coverage.

  • Documents Needed When Renewing Coverage (PDF)
  • Request for Review of Child Health Plus Premium Contribution Level (PDF)

  
  

Pharmacy

• Pharmacy Forms

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Advance Directives/Advance Care Planning – New York

• NYSBA Living Will and Health Care Proxy Forms

Medicaid

Looking for Medicaid forms?