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Participant Handbooks and Forms

PA Health and Wellness Participant Handbook (PDF)

Authorization to Disclose PHI (PDF)

Revocation of Authorization to Disclose PHI (PDF)

Authorization to Disclose PHI (Spanish) (PDF)

PHW can provide vital documents and other information you need in other formats such as compact disc, Braille, large print, DVD, electronic communication and other formats if you need them, at no cost to you. Please contact Participant Services at 1-844-626-6813 or 1-844-349-8916 (TTY) to ask for any help you need.  Depending on the information you need, it may take up to 5 business days for PHW to send you the information.