Forms

Please select and complete the appropriate forms. Incomplete forms will be returned for additional information. 

All forms can be mailed to:
American Health Care
3850 Atherton Road
Rocklin, California 95765

You may also fax all information to: 916-960-0246

Downloadable Forms:
Authorization for disclosure of Protected Health Information (PHI) Form
Direct Member Reimbursement Form

Autorización para la divulgación de información de salud protegida (PHI) de forma
`Este es el formulario de reemboiso directo