How to Submit Your Member Qualification Form
Have your Personal Care Physician complete your form and submit it to HAP in one of the following ways:
- Online by logging into hap.org and selecting the Health Engagement application.
- Email the form to firstname.lastname@example.org
Email Security Notice: Please be aware that HAP cannot guarantee the confidentiality or security of any information you send to us over the Internet when using email.
- Fax the form to (248) 552-9416.
- Mail the form to HAP 26877 Northwestern Hwy., Ste. 420, Southfield, MI 48033-9903.