The forms below are intended for use only by current or previously covered healthcare providers. Questions related to the use and/or completion of the forms should be directed to the SIP Insurance Services team at (352) 273-7006 -or- 844-MY FL SIP, or via email at one of the following addresses:
Release of Claim and/or Suit Information
University of FloridaAuthorization for Release of Information |
|
Florida State UniversityAuthorization for Release of Information |
|
University of Central FloridaAuthorization for Release of Information |
|
Florida International UniversityAuthorization for Release of Information |
|
Florida Atlantic UniversityAuthorization for Release of Information |