Consent for Case Management - FEP 2025

1. Click ‘Get Form’ to open the Consent for Case Management - FEP in the editor.
2. Begin by entering your name in the designated field. This identifies you as a member or authorized representative.
3. Review the agreement carefully, ensuring you understand that your case manager may contact you and your care team regarding healthcare needs.
4. In the signature section, sign your name to authorize the release of medical information necessary for creating and updating your care plan.
5. Print your ID number in the specified field to confirm your identity within the program.
6. Indicate your relationship to the member if applicable, and enter today’s date to finalize the agreement.
7. Once completed, save a copy of this document for your records, as it is valid for one year from the date signed.

Start using our platform today to easily complete and manage your Consent for Case Management - FEP form online, for free!