Submit information to R H Administrators effortlessly with the correct form. All PDF forms must be either faxed or mailed to our office.

Web-based forms:
R H Administrators Quote Request
R H Administrators Enrollment Form
R H Administrators Change Form
R H Administrators Termination Form

PDF-based forms:
Accident/Injury Details Request Form
Authorization to Release Information Form
Other Insurance Information Form
Patient Pre-Existing Questionnaire
Provider Pre-Existing Questionnaire
R H Enrollment Form
Student Verification Form
Subrogation Authorization Form
FBISD Form
Willacy County Form

This information is available in Adobe® Portable Document Format (PDF).  PDF allows for a cross-platform PostScript-based file containing any combination of text, graphics and images.  If you do not want to read the document online, you can download and save the file for later use.


To download a PDF file, click on the name of the file you are interested in reading.

A dialog box from your browser will appear asking if you want to save the file.  Specify where you want the file saved on your computer.  Once the file is on your local hard drive, you can view, navigate or print the documents using Adobe Acrobat® software.  If you do not have this software, a copy of Adobe Reader® is required.  Adobe Reader® is available free of charge in various languages and operating systems including Windows, Apple and UNIX.