Image of Puerto Rico Provider header
You are here: Home > Provider Forms

¿Habla Español?
Image of Physicians completing a form

Provider Forms
 
Please note that the documents outlined below may require Adobe Acrobat Reader. If you do not have this software currently installed, a free download can be obtained directly from Adobe.


APS Healthcare (Mental Health) - Outpatient Treatment Plan Form  Adobe PDF button image
 
Non-covered Services Waiver Form Adobe PDF button image
 
Patient Referral Authorization Form Adobe PDF button image

Last Reviewed:  June 5, 2007
 

Home | Privacy | Terms of Use | Newsroom | About Humana Military 

© Copyright 2007, Humana Military Healthcare Services Inc., administrator for the Department of Defense’s TRICARE program.