Member Handbooks and Forms

Handbooks

Delaware First Health members are able to get a member handbook at all times. You can get a handbook by calling Member Services at 1-877-236-1341 (TTY: 711) 8am-7pm EST or by downloading a copy below.

• 2026 DSHP/ DHCP Member Handbook - English (PDF)
• 2026 DSHP/ DHCP Member Handbook - Español (Spanish) (PDF)
• 2026 DSHP/ DHCP Member Handbook - 中文 (Chinese) (PDF)
• 2026 DSHP/ DHCP Member Handbook - Kreyòl Ayisyen (Haitian Creole) (PDF)

• 2026 LTSS Member Handbook - English (PDF)
• 2026 LTSS Member Handbook - Español (Spanish) (PDF)
• 2026 LTSS Member Handbook - 中文 (Chinese) (PDF)
• 2026 LTSS Member Handbook - Kreyòl Ayisyen (Haitian Creole) (PDF)   

Guides

• LTSS Companion Guide - English (PDF)
• LTSS Companion Guide - Español (Spanish) (PDF)

• Quick Guide Benefits Booklet - English (PDF)
• Quick Guide Benefits Booklet -  Español (Spanish) (PDF)
• Quick Guide Benefits Booklet - Kreyòl Ayisyen (Haitian Creole) (PDF)

• Provider Directory - New Castle (PDF)
• Provider Directory - Kent (PDF)
• Provider Directory - Sussex PDF)
• Provider Directory (Machine Readable)

• Drug Formulary List (PDF)
• Drug Formulary List (Machine Readable)
• Drug Formulary List (Searchable)

• Pharmacy Over-the-Counter (OTC) Brochure - English (PDF)
• Pharmacy Over-the-Counter (OTC) Brochure -  Español (Spanish) (PDF)

Forms

• Grievance and Appeals Authorized Representative Designation (PDF)
• Member Appeal Form (PDF)

• Notification of Pregnancy (NOP) Form - English (PDF)
• Notification of Pregnancy (NOP) Form - Español (Spanish) (PDF)
• Notification of Pregnancy (NOP) Form - Kreyòl Ayisyen (Haitian Creole) (PDF)

• Authorization to Use and Disclose Health Information - English (PDF)
  
• Authorization to Use and Disclose Health Information - Español (Spanish) (PDF)
• Authorization to Use and Disclose Health Information - Kreyòl Ayisyen (Haitian Creole) (PDF)

• Revocation of Authorization to Use and/or Disclose Health Information (PDF)

• Request for Accessing/Inspecting/Copying Health Information (PDF)

• Request for Restrictions on Use and Disclosure of Health Information (PDF)

• Request for Accounting of Disclosures of Health Information (PDF)

• Request for Amendment of Health Information Form (PDF)

Any documents and items offered in electronic format can be requested in paper format. To request a document in paper format, please contact Member Services at 1-877-236-1341 (TTY: 711). Once you have completed your request, the paper format item(s) will be mailed to you.