Get Fidelis Change Pcp

This guide provides a step-by-step approach to filling out the Fidelis Change Pcp form online. Whether you are changing your primary care physician for the first time or need assistance, this comprehensive guide will help you through the process.

Follow the steps to successfully complete your Fidelis Change Pcp form online.

1. Click the 'Get Form' button to access the Fidelis Change Pcp form. This action will allow you to view and edit the document required for making your primary care physician change.
2. Begin by entering your personal information in the designated fields. This typically includes your full name, date of birth, and contact information. Ensure all details are accurate to avoid processing delays.
3. Next, provide your current primary care physician's information. Input their name, office address, and contact number as required. This step is crucial for the transition of your records to the new physician.
4. Now, enter the information of the new primary care physician you wish to select. Include their name, specialty, address, and phone number. Double-check that the new provider is listed as a participant in the Fidelis Care network.
5. Review any additional fields on the form that may pertain to your situation. This can include questions about your health conditions or preferences for care. Take your time to respond thoroughly.
6. After completing all sections, review the entire form for accuracy and completeness. Ensure there are no typos or missing information that could hinder your submission.
7. Once you are satisfied with the information provided, you can save your changes, download the completed form, or print it out based on your needs. Ensure to keep a copy for your records.

Take the first step towards changing your primary care physician by completing the Fidelis Change Pcp form online today.