Gender reassignment surgery gender reassignment surgery 2026

1. Click ‘Get Form’ to open the Gender Reassignment Surgery form in the editor.
2. Begin by filling out Section 1, providing general information such as the member's name, administrative reference number, and date of birth. Ensure all fields are completed accurately.
3. Move to Section 2, where you will provide patient-specific information. Indicate whether this is a new or continued treatment and answer questions regarding gender dysphoria and consent capacity.
4. If applicable, complete Section 3 for female-to-male services or Section 5 for male-to-female services. Select the requested services and confirm referral letters from qualified mental health professionals.
5. In Section 6, gather and upload all necessary documentation including medical records and treatment descriptions to support your request.
6. Finally, review all sections for accuracy before signing the form in Section 8. Remember that this form cannot initiate a precertification request; you must call the Precertification Department or submit electronically.

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