Get 2014 Member Notification Form For Health Actions ...

The 2014 Member Notification Form for Health Actions is an essential document for members participating in the UnitedHealth Personal Rewards program. This guide will provide clear instructions on how to properly complete the form online to ensure that your health actions are credited accurately.

Follow the steps to successfully complete the online form.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. Enter the required patient information, including your member identification number and group identification number, ensuring that this information matches exactly with your UnitedHealthcare Medical Plan ID card.
3. Fill in your personal details, such as last name, first name, middle initial, address, city, state, zip code, and optional phone and email information.
4. Sign and date the form in the designated area, confirming that all provided information is accurate.
5. Proceed to document your health actions, checking the appropriate boxes for each biometric test you have completed, such as Body Mass Index, LDL cholesterol, Fasting Blood Sugar, and Blood Pressure.
6. For each health action checked, attach the required evidence of completion, such as test results from your provider or a printout for the online health assessment.
7. Make sure to include the date of service for each health action listed.
8. After thoroughly reviewing the completed form and its attachments, either download, submit, or share your documents through the available means, ensuring they are sent to the specified address or secure fax number.

Complete your health actions notification form online today to ensure you receive your program rewards!