Forms for Members
General
Authorization to Release Member Information
This form is to authorize the release of your Protected Health Information (PHI) such as dental claims history, benefits information, etc. to someone else (for example: your spouse, your daughter or son, etc.).
Claim Form
HDS_Form_IDP_Update_2025 fillable
HDS_Form_IDP_Update_2025 fillable
Individual Dental Plan
Mail-In Application for Enrollment
Update Form For Individual Dental Plan
This form is for Individual Dental Plan members only. To make a change to your Individual Dental Plan online, please log onto the HDS Member Portal. If you have a group plan through your employer, please contact your company’s benefits administrator to make updates to your plan information.