Formulario de selección del médico de atención primaria

Complete this form to select or change your primary care physician. El cambio entrará en vigor el primer día del mes siguiente.

If you are choosing a primary care physician (PCP) in a different plan medical group — for example, you are switching from a doctor in Sharp Rees-Stealy to a doctor in the Sharp Community Medical Group — your current referrals or prior authorizations for specialists, special supplies or equipment will be voided. Debe solicitar a su nuevo PCP nuevas referencias o autorizaciones previas.

You should receive a Sharp Health Plan member ID card with your updated provider information five to seven business days before the effective date. If you have any questions or need immediate assistance, please contact our Customer Care team at 1-858-499-8300 or toll-free at 1-800-359-2002, from 8 am to 6 pm, Monday through Friday.

¿Actualmente es usted paciente del médico que está solicitando?*

*Campo obligatorio