EasyCare Forms and Personal Health Materials
Appointment of Representative Form
You may appoint a relative, friend, attorney, or anyone else whom you trust to act on your behalf. A representative who is appointed by the court or who is active in accordance with State law may also file an appeal or grievance for you. To appoint a representative you must complete an Appointment of Representative Form.
You can give us a copy of the form or letter or mail it to: VNS HealthHealth Plans – Care Team 220 East 42nd Street New York, NY 10017