Primary care physician selection form

Please complete this form to select or change your primary care physician. The change will be effective on the first day of the following month. You should receive a Sharp Health Plan member ID card with your updated provider information 5-7 business days before the effective date. 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 a.m. to 6 p.m., Monday through Friday. Search for a doctor here. 

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

* Required field.