TotalCare Confidential Communications Request Form

Use this form to ask TotalCare to send your confidential or sensitive health information to a different address, phone number, or email. This includes things like notices about medical services or other communications that include private health details. If approved, this request will only apply to TotalCare communications with confidential information.

Do not use this form to:

• Make a one-time request
• Change your primary contact information
• Ask for all messages from TotalCare to be sent by email (we do not send general communications by email)

To update your regular contact information, complete the Update Contact Information Form

If you need help with this form, call Member Services.