Medicaid HealthChoices Resource Request
Please complete this form if you are requesting provider or member printed resources regarding the Medicaid HealthChoices changes. We appreciate your willingness to spread awareness throughout your networks and community at large.
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Name *
Email *
Organization *
What address can we ship the resources to? *
How many Spanish member resources are you requesting? (https://paoralhealth.org/wp-content/uploads/2022/05/Member-One-Sheet-Spanish.pdf)
Where will you be distributing the resources and with whom? *
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