This form is for members only.

This form is NOT intended for submitting open records requests. 

All alternate format document requests made by non-members must be submitted through the DCH Open Records webpage.

 

Purpose and Overview

This form is used to submit requests to receive SHBP documents in alternate formats. It ensures all individuals have equitable access to information.


Submitting your request through this form helps SHBP track workflow, prioritize tasks, and ensure all alternate format document requests are addressed.

Processing times may vary based on the type of request and the receipt of complete requirements.

  • Start
  • SHBP Alternate Format Document Request
  • Complete

Requester Information

Are you a State Health Benefit Plan (SHBP) member or a legal power of attorney of an SHBP member?
All non-SHBP members are required to submit requests for alternate formats of documents via DCH Open Records.
Verification of SHBP membership will be required.

Request Details

Please provide the link to the document you are requesting in an alternate format. To copy the document link you must first locate the document on the SHBP website.
Please specify the format you are requesting to receive the document in. .
Note
If the request can be satisfied by SHBP, the alternate format of the document will be provided to the member via email unless explicitly stated otherwise.