Forms and Documents

ODA Wellness Trust Forms and Documents

This page contains form and documents that may be useful to you as you enroll in a plan with the ODA Wellness Trust.

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Forms should be completed, printed and faxed to the ODA Insurance at 614-340-9444.

An email will be generated to confirm receipt of all faxes submitted to ODAWT (614) 340-9444 within one business day.  Please include with your fax an email address the fax receipt confirmation should be sent.   If you do not receive a confirmation of fax receipt (please check your junk/spam file), the ODAWT has not received your fax.

Extreme caution should be used when sending personal health information via regular email.

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