Forms and Guides
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Forms
- Authorization to Release medicaid Records - English | Spanish
- Common Injury Accident Questions and Answers
- Income Verification Form - English | Spanish
- End of Life Legal Forms - English | Spanish
- Health Insurance Marketplace Application - English | Spanish
- IRS 1095-B Form
- Lottery Gambling Winnings Monthly Income
- Member Complaint/Grievance Form (LD-1) - English | Spanish
- Member Step Therapy Appeals Form (LD-5) - English | Spanish
- No Income Attestation Form - English | Spanish
- Oklahoma Voter Registration Form
- Request for Fair Hearing
- Request for State Fair Hearing (LD-1s)
- Request for Telephonic Hearing (LD-4) - English | Spanish
- Retroactive Eligibility Application for SoonerCare - English | Spanish
- Self-Employment/Cash Income Statement - English | Spanish
- Transitional Medical Assistance Reporting - English | Spanish
- 12 Month Profit and Loss Worksheet - English | Spanish
- Voter Registration
Other Documents
- EPSDT – A Guide to Keeping Your Kids Healthy/SoonerCare Member Guide - English | Spanish
- MAGI (Income Fact Sheet) - English | Spanish
- Referral Guide for SoonerCare Members - English | Spanish
- Document Verification Guide - English | Spanish
- SoonerCare Member Handbook - English | Spanish
- SoonerCare FAQs - English | Spanish
- SoonerPlan Family Planning Brochure
