Member Service Forms

Member Service Forms

Click the link below to download the Bank Draft Authorization Form:
Click the link below to download the Credit/Debit Card Draft Authorization Form:
Click the link below to download the Member Communications Authorization Form:
Click the link below to download the Average Billing Form:
Click the link below to download the Critical Care Form:
 
 

 

For any questions on what day of the month your payment will draft or
about the draft process, please contact the HCEC Member Services department at 936-544-5641!