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Medical Management

Email Consent Form

Use this form to grant permission for our Case Management department to communicate with a beneficiary via email.

You may fax this form to 1-888-965-8438 or mail it to:

Health Net Federal Services, LLC
Attention: Case Management
P.O. Box 9528
Virginia Beach, VA 23450-9528

  • Created: Aug 1, 2022
  • Modified: Feb 1, 2021
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