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Cook Children's Health Plan

CHIP Forms

Baby Doctor Smiles

Value Added Services

Our VAS gift card forms can now be found within our MyCookChildren's Member Portal. You can access these forms by signing up or logging into the portal here.

Once signed up and logged in, the forms can be located under VAS Forms.


The following forms are available to download in PDF format.

We're here to help

Please call Member Services if you have any questions about these forms at 1-800-964-2247. Monday - Friday from 8am - 5pm.