Patient forms and information (9)
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Alternative access standards
Learn more about alternative access standards for Medi-Cal members.
Appeal and grievance form
Use this form if you have an individual or family plan.
Interpreting services
Language assistance services are available to you at no cost.
Medicare Shared Savings Program
Learn more about the Optum California ACO and the high-quality care we offer Medicare patients.
Member reimbursement claim form
Please use this form to ask to be reimbursed for care you paid for.
New patient form - California
Download and fill out the personal information form.
Patient rights and responsibilities
This document explains your rights and responsibilities as an Optum patient.
State consumer privacy notice
Depending on which Optum product or service you use, and your state of residency, you may have rights as outlined in this Notice.
Surprise billing protection
Know your rights and protections against surprise billing.