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Information for All Providers - Third Party
Jul 1, 2009 To obtain coverage information when there are more than two carriers, call Computer. Sciences Corporation at: (800) 343-9000. Page 4
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member-phi-authorization-english.pdf
By completing and signing this form, I, or my legal representative, agree to allow Aetna to share my PHI with the people or companies listed below. By Aetna, I
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Permission to Contact Form
Permission to Contact Form. First Name. Last Name. Address. City. State. ZIP. Phone Number. Phone Type (Cell / Landline). Email (if applicable). Best Day Time
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