Enroll in USFHP

Please download and fill out the following documents to enroll in USFHP.

1. READ ME FIRST! 
2. Application (Enrollment) Form 
   PLEASE NOTE - Only the Application form allows you to type directly onto the form before printing. All other forms (below) must be printed first and then hand written.
3. Other Health Insurance Information Form 
4. Payment Options Form 
5. Allotment Authorizations Form 
6. Automatic Payment Form 
   (Complete to have payment automatically deducted from credit card or checking account.)
7. Provider Directory (Choose a Doctor at a location near you.)

These files are in the Adobe Acrobat PDF   format.  Not sure how to download the above documents to your computer?  View Instructions >

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