Member Handbooks and Forms
Handbooks
- Sunflower 2025 Member Handbook
- Sunflower 2024 Member Handbook
Provider Directory
- Provider Directory - Contact customer service at toll free 1-877-644-4623 for a copy of this directory. Please note: our online Find a Provider tool is the most current source of network provider information.
- Region 1 (PDF) - KANSAS COUNTIES: Johnson, Leavenworth, Wyandotte MISSOURI COUNTIES: Platte, Clay, Jackson, Cass
- Region 2 (PDF) - KANSAS COUNTIES: Atchison, Barber, Barton, Brown, Cheyenne, Clark, Clay, Cloud, Comanche, Decatur, Dickinson, Doniphan, Douglas, Edwards, Ellis, Ellsworth, Finney, Ford, Franklin, Geary, Gove, Graham, Grant, Gray, Greeley, Hamilton, Haskell, Hodgeman, Jackson, Jefferson, Jewell, Kearny, Kiowa, Lane, Lincoln, Logan, Marshall, Meade, Miami, Mitchell, Morton, Nemaha, Ness, Norton, Osborne, Ottawa, Pawnee, Phillips, Pottawatomie, Pratt, Rawlins, Republic, Riley, Rooks, Rush, Russell, Saline, Scott, Seward, Shawnee, Sheridan, Sherman, Smith, Stafford, Stanton, Stevens, Thomas, Trego, Wabaunsee, Wallace, Washington, Wichita COLORADO COUNTIES: Yuma, Kit Carson, Cheyenne, Kiowa, Prowers, Baca MISSOURI COUNTIES: Platte, Buchanan, Andrew, Holt NEBRASKA COUNTIES: Richardson, Pawnee, Gage, Jefferson, Thayer, Nuckolls, Webster, Franklin, Harlan, Fumas, Red Willow, Hitchcock, Dundy OKLAHOMA COUNTIES: Cimarron, Texas, Beaver, Harper, Woods, Alfalfa
- Region 3 (PDF) - KANSAS COUNTIES: Allen, Anderson, Bourbon, Butler, Chase, Chautauqua, Cherokee, Coffey, Cowley, Crawford, Elk, Greenwood, Harper, Harvey, Kingman, Labette, Linn, Lyon, Marion, McPherson, Montgomery, Morris, Neosho, Osage, Reno, Rice, Sumner, Wilson, Woodson MISSOURI COUNTIES: Newton, Jasper, Barton, Vernon, Bates, Cass OKLAHOMA COUNTIES: Alfalfa, Grant, Kay, Osage, Washington, Nowata, Craig, Ottawa
- Region 4 (PDF) - KANSAS COUNTIES: Sedgwick
Forms
- PCP Change Form Use this form to change your primary care physician (PCP)
- Appeal & Grievance Authorized Representative Form
- Appeal Form (PDF)
- Authorization to Disclose Personal Health Information (PHI) Form
- Revocation of Authorization to Disclose Personal Health Information (PHI) Form
- Office Visit Checklist - Use this worksheet to help you prepare for your appointment and for writing notes during your visit. Take charge of your health by asking questions and sharing information, so your PCP can help you receive the best possible care.
- Prescription Claim Reimbursement Form
- Mileage Reimbursement Form (PDF) - Transportation log, mileage log, gas reimbursement. SafeRide form.
- Notification of Pregnancy Form
- Birthing Plan
- My Dental Care Passport - My Dental Care Passport is designed to improve the dental office visit for people with disabilities by letting individuals and their families/caregivers voice their specific needs.
- Integrated Life Plan (PDF)