Member Handbooks and Forms

Handbooks

• Georgia Families Medicaid and PeachCare for Kids Handbook (PDF)

How to Search Your Handbooks and Directories

1. Open the handbook
2. Press Ctrl F to open the search tool
3. Type the Word you are looking for into the text box
4. Press enter.

Forms

• Member Data Change Form (PDF)
• HIPAA Authorization to Disclose PHI Form (PDF)
• HIPAA Revocation of Authorization to Disclose PHI Form (PDF)

Please print this form and mail it back to Peach State Health Plan.

The mailing address is:
Peach State Health Plan
Member Services Department
1100 Circle 75 Pkwy
Suite 1100
Atlanta, GA 30339

• Health Risk Assessment (PDF)
• Member Notification of Pregnancy (PDF)

Please print these forms and mail them back to Peach State Health Plan.

The mailing address is:
Peach State Health Plan
Case Management Department
1100 Circle 75 Pkwy
Suite 1100
Atlanta, GA 30339