Member Handbooks and Forms
- 2025 MississippiCAN Member Handbook (PDF) (Effective 7/1/2025)
- Member Tip Sheet (PDF)
- Adult Immunization Record (PDF)
- Adult Wellness Visit Checklist (PDF)
- PCP Change Request Form (PDF)
- Notification of Pregnancy Form (PDF)
- Member Authorization to Disclose Personal Health Information (PDF)
- Revocation of Authorization to Disclose Personal Health Information (PDF)
- Member Appeals Authorized Representative Form (PDF)