Primary care physician selection form

Please complete this form to select or change your primary care physician. We will mail a Sharp Health Plan member ID card with your updated provider information to you within 7 - 10 business days of processing this form. If you have any questions or need immediate assistance, please contact our Customer Care team at 1-858-499-8300 or toll-free at 1-800-359-2002, from 8 am to 6 pm, Monday through Friday. 

Are you a current patient of the doctor you are requesting?*

* Required field.