Authorization Form
If you have a caregiver, we cannot speak to them about your care unless you sign a “Member Standing Authorization Form,” allowing us to do so. Likewise, if you are a caregiver for an Advantage MD member, the member must provide authorization for Advantage MD to speak with you.
Print, fill out and sign the form, and either mail or fax it to us. Our mailing address and fax number are on the second page of the form.