HS Secure File Transfer for Authorization Request

Send files securely to CenCal’s Health Services UM Department
* Required fields are marked with asterisk
SENDER INFORMATION
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MEMBER INFORMATION
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< Please select below the type of documentation you are submitting >
< Please check URGENT ONLY if delaying member's treatment will affect life or limb >
*Note: Please do not upload any files with special characters in the file name (including quotation marks " "), as this will cause errors saving to our internal directories and make the file transfer fail*
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Drop files here, or browse to attach files
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For assistance with this Form, please call Health Services UM Department at (805) 562-1082 or contact us on our website www.cencalhealth.org.

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