Contact Us Form

Have a question? First, refer to our Common Questions.

If you still need to contact us directly, simply fill out this Contact Us Form.

Need to submit a secure message? Sign on and complete the secure Contact Us form. You need to be a registered user of optimahealth.com to use the secure version of the form.

* Indicates Required Fields

First Name: *

Last Name: *

Organization:

Group Size:

2-99
100+

Indicate Group Size if attaching enrollment applications or PHI documents.

Email: *

Please review our Privacy Policy for our use of your email address

Address:

City/State:

Zip Code:

Daytime Phone:

Licensed/Appointed in state(s):

I would like information on:

Health Products Behavioral Health Products Appointment Information Other

Question:

How would you like to be contacted? *

Phone Mail Email

Please note we will contact you during normal business hours.

If the response to this inquiry contains personal health information, we will contact you by phone or by US mail. This is for your protection. If you prefer an emailed response, sign in and submit your question using our secure form.