Primary care physician selection form

Please complete this form to select your Primary Care Physician. We will send an email response to your request within two business days.  We will mail a Sharp Health Plan member ID card to you within five business days of receiving your enrollment information.  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?*

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