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Welcome to Summit Health


* Please note that Moda performs some administrative functions for Summit Health. Contact us if you need more help.

Administrative forms

General forms

  • Advance Directive - A patient’s wishes for their care, should they be too ill or hurt to express it themselves
  • Coordination of benefits form - Allows a partner’s or spouse’s coverage to help cover a procedure for a patient
  • Transition of care form - For patients transitioning on to a new plan. This form may also be used for a continuity of care request form for providers terming from network.

Authorization forms


Behavioral Health forms

Last updated Oct. 1, 2021

Contact us

Have questions? We’re here to help. Call us today at 844-827-2355 (TTY users, please call 711). Our customer service team is available from 7 a.m. to 8 p.m., Pacific Time, seven days a week from Oct. 1 to March 31. After March 31, your call will be handled by our automated phone system on weekends and holidays.

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