Documents and forms


Registration & Prescription Order Form
(624 KB) Download PDF
English | Espanol

Physician Fax Form
(80 KB) Download PDF
English | Espanol

Consent for Release of Protected Health Information
(196 KB) Download PDF
English

Request for Restriction of Protected Health Information for Services & Treatment
(160 KB) Download PDF
English

How to Read your Label
(196 KB) Download PDF
English

2021 Humana Health and Wellness Catalog and Order Form
(1.1 MB) Download PDF
English | Espanol

IL MMAI Humana Gold Plus Integrated Health and Wellness Catalog and Order Form
(586 KB) Download PDF
English | Espanol

Florida DSNP Over-the-Counter (OTC) Health and Wellness Product Order Form
(586 KB) Download PDF
English | Espanol

2021 Humana Healthy HorizonsTM in South Carolina Health and Wellness Catalog and Order Form
(991 KB) Download PDF
English | Espanol

Patient Bill of Rights
(119 KB) Download PDF
English


Humana Pharmacy® Specialty Forms

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