Need claim forms? Order using the Medicaid Claims Order Form, or order online using your credit card.

NOTE: The fax machine receiving the fax requires that the image setting be set to FINE or SUPERFINE. If you cannot change the image settings on the fax machine, and the images are not viewable, it will be necessary to mail a copy of the required documentation, along with the appropriate cover sheet, to the following address: Provider Enrollment, PO Box 7070, Tallahassee, FL 32314-7070.

To access the following documents, you must have Adobe Acrobat Reader installed on your machine.

To save a document from the list below, right-click the link and then select "Save Target As..."