Integrated Care Collaboration Improving Access to Healthcare in Central TexasIntegrated Care Collaboration
Improving Access to Healthcare in Central Texas

  • Home
  • About ICC
  • Projects
  • What's Happening
  • Information Systems
  • Library
  • Contact Us
  • HAITI RELIEF EFFORTS
  • ICC Member Resources
Home

ICC Forms

 

ICC Authorization Form (English)

ICC Authorization Revocation (English)

ICC Authorization Q&A (English)

 

ICC Authorization Form (Spanish)

ICC Authorization Revocation (Spanish)

ICC Authorization Q&A (Spanish)

 

Suggested Process for Obtaining Authorizations

ICC Member List

ICare New System User Request Form (ICC Confidentiality Agreement)

 

 

 

ICC of Central Texas
2028 E. Ben White Blvd. Suite 115   Austin, TX 78741
Phone: (512) 804-2090     Fax: (512) 804-2096
Contact Us