Member Forms

Authorized Representative Form
Choose to have a person, your representative, communicate with Alameda Alliance for Health on your behalf.

Immunization Registry Form
To start or decline sharing immunization (shot) information.

Member Request for Reimbursement Form
Please use one form for each health expense you are asking Alameda Alliance for Health (Alliance) to reimburse to you.

Transportation Request Form
Please use this form to request Non-Emergency Medical Transportation or Non-Medical Transportation from Logisticare.



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