Provider Office Forms

To download Provider Office Forms, please click on the form below that you need.

PCP Designation Form - English
PCP Designation Form - Spanish
Staying Healthy Tip Sheet (0-3 years) English
Staying Healthy Tip Sheet (0-3 years) Spanish
Staying Healthy Tip Sheet (4-8 years) English
Staying Healthy Tip Sheet (4-8 years) Spanish
Staying Healthy Tip Sheet (9-11 years) English
Staying Healthy Tip Sheet (9-11 years) Spanish
Staying Healthy Tip Sheet (12-17 years) English
Staying Healthy Tip Sheet (12-17 years) Spanish
Staying Healthy Tip Sheet (18 and older) English
Staying Healthy Tip Sheet (18 and older) Spanish
Staying Healthy Assessment Form (0-3 years) English
Staying Healthy Assessment Form (0-3 years) Spanish
Staying Healthy Assessment Form (4-8 years) English
Staying Healthy Assessment Form (4-8 years) Spanish
Staying Healthy Assessment Form (9-11 years) English
Staying Healthy Assessment Form (9-11 years) Spanish
Staying Healthy Assessment Form (12-17 years) English
Staying Healthy Assessment Form (12-17 years) Spanish
Staying Healthy Assessment Form (18 and older) English
Staying Healthy Assessment Form (18 and older) Spanish
Report of Health Examination for School Entry
UM Prior Authorization Request Form
KFHC Member Grievance Form - English
KFHC Member Grievance Form - Spanish