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Optum Idaho - Identification Information

Please enter the following Information to Proceed. All Fields are required.

IMPORTANT NOTE: This Information is used to retrieve your submission if you are disconnected during the process or wish to wait to complete the form at a later time.

The combination of your name, Optum ID, and email address uniquely identifies you and your requests in the system. Please use the same information each time, so that when on the Summary Page, you can view all of your requests together.

Don't have an Optum ID or forgot it? Click Here

Important Note: Please use Chrome with this form. Internet Explorer is not recommended due to performance issues.