Community Care Plan (“CCP”) wants to make sure that our members get the best health care. The answers to these questions will help you or your child's Primary Care Provider (PCP) and our nurses know what you or your child need.
- Answer the questions within 60 days of enrollment or CCP's request date and get a $20 reward! Learn more on our Rewards page.
- Pregnant members can get $25 for completing this form within 60 days of enrollment or CCP’s request date.
- It should take less than 8 minutes to finish. You will get FREE resource links and be able to have a copy of your answers emailed to you at the end. You will see the camera picture!
- Your information is private. The answers do not change you or your child's benefits.
- If you need help filling out this form, please call us at 1-866-384-2926 TTY/TDD 711 Monday to Friday from 8:00am to 7:00pm.
- You can also take the form with you to your next doctor's appointment.