Forms and Applications
For state specific group application forms, click here.
Other Forms
Claim Form
Claims Appeal Procedures
TruAssure Insurance Company® Payment Authorization
HIPAA Notice of Privacy Practice and Rights
Authorization for Release of Information
To complete with a digital signature and send electronically, please download this form with Adobe or another PDF reader.
Authorization for Release of Information (Español)
Para completar con una firma digital y enviar electrónicamente, por favor descargue esta forma por el Adobe u otro lector PDF.