SELECT PCP

SELECT PCP

Select Your PCP

Please note that this form is only a request to add a Primary Care Physician. All PCP requests are subject to verification. We will notify you when your selection has been confirmed. Only plan members are authorized to add a PCP. You can also select your PCP online thru Access RMHP, our secure website. Please click here to register!

Use this form to add a PCP only if:

  • Your current enrollment information is on file with our office and
  • You have not yet selected a valid PCP

Required Information

Step 1: Member Information

(e.g. 012345678-01)
(to send email confirmation)

Step 2: Dependent and Provider Information

Provider Information is required to confirm the PCP selection. If the PCP information is not known, please:

  • Search in the Online Provider Directory
  • Contact the PCP
  • Contact Customer Service at (800) 346-4643
Please indicate a PCP for each Member (if applicable):
(Please contact the PCP directly to be sure they are accepting new patients)
(Please contact RMHP or the PCP to be sure the PCP serves your Enrollment type)