QuadMed Forms

Driving Age Minors Form
Purpose: This form may be used to allow minors of legal driving age (16 or older) to receive routine care and services at QuadMed, LLC clinics without a parent or proxy present.

Minors Parent Proxy Form
Purpose: This form may be used to allow an adult other than a parent to serve as a proxy decision maker for routine medical care and services at the QuadMed, LLC clinics.

Health Care Flex Reimbursement Form
Purpose: This form may be used to apply for reimbursement of eligible health care expenses. You will need to print out the Health Care Flex Reimbursement form, fill out and sign the form, attach supporting documentation and send to QuadMed Claims in West Allis. Please read the instructions on the form carefully.