How to Submit an ROI or AoR Form

If you'd like to authorize Spring Health to share your information with someone else, or appoint someone to help manage your care, you can complete this process directly with Spring Health — digitally through our Support Center or by mail. You do not need to go through your provider to submit or request these forms; our Care Support team handles ROI and AoR requests directly.

This guide covers the general process for both forms, including options for members who don't have an email address on file.

Understanding the difference between an AoR and an ROI

Types of Appointed Representatives:

• Third-Party Representative: A trusted family member, spouse, parent, or close companion. You can revoke this designation at any time.
• Legal Guardian or Appointed Legal Representative: Someone with legal documentation demonstrating guardianship or legal representation (such as a court order or custody paperwork).

If you're unsure which form you need: an AoR is for someone coordinating your care, while an ROI is strictly for sharing information without granting account access.

Do You Need a Form At All?

In some cases, you don't need to submit a new form:

• Getting your own records: If you'd like a copy of your own records sent to the email address on your Spring Health account, you typically don't need an ROI — just reach out to our Care Team and we can help. 
• You already have a representative on file: If you have a valid AoR on file, they generally don't need a new ROI to receive your records or help coordinate services on your behalf.
• Using an authorization you already have: If your insurance company, disability provider, or another entity has its own authorization form and you've already signed it, we may be able to accept that instead of a separate Spring Health form, as long as it meets certain requirements. Contact our Care Team and we can review it for you.
• Not sure if we already have something on file? Reach out to our Care Team before filling out a new form — we're happy to check whether an existing authorization already covers your request, so you don't have to start over.

If none of the above applies to your situation, follow the steps below.

Step 1: Complete Your Form

Download and print the blank forms: Spring Health ROI | Spring Health AoR

Key Instructions for All Forms:

• Date Format: Please format all dates as mm/dd/yyyy.
• Signatures:
  • Wet signatures (pen on paper) are always acceptable.
  • E-signatures are only accepted if they meet e-Sign Act requirements (must include a date/time stamp, geolocation, and IP address). DocuSign is an acceptable platform for e-signatures.
• Have an email address? You can ask our Care Team to send you a secure electronic version of the form to sign, instead of printing it.
• Don't have an email address? No problem — see the digital submission option below, or mail your form in.

AoR-Specific Instructions:

• Complete questions 1–3 with your information. 
• In Section 1, select the checkbox that matches your request. 
• Complete either Section 2 or Section 3:
  • Section 3 must be completed by the Legal Guardian or Appointed Legal Representative, if applicable.
• If you don't have an email address, indicate "N/A" where email is requested.

ROI-Specific Instructions:

• Clearly list the information you're authorizing Spring Health to share. 
• If you want all of your care eligible for disclosure, use your care start date and choose an end date far enough in the future (for example, one year out). 
• If you'd like a copy of the disclosed information yourself, add yourself as a recipient under "Disclose my information to."

Step 2: Submit Your Documents

Once your form is signed, submit it using one of the following methods:

Method A: Digital Submission (No Email Required)

1. Visit the Spring Health Support Center.
2. If you have an email address on file, log in and submit through the Support Center as usual. 
3. If you don't have an email address, enter "N/A" for the email address field. 
4. Select Paperwork Requests, then choose Other. 
5. In the Description field, include:
   1. Your first and last name
   2. Your date of birth
   3. The phone number associated with your Spring Health account
6. Upload the completed and signed form under the "Attachments" section and click submit.

Method B: Mailing Your Forms If you're unable to submit your form digitally, mail your completed and signed documents to:

Spring Health 60 Madison Ave, Floor 2 New York, NY 10010

Need Help? 

Your privacy and security are extremely important to us. If you have questions or need help completing or submitting your forms, our Care Support team is here to guide you through the process — you don't need to involve your outside provider. Please reach out to us at springhealth.com/support and we'll work with you to make the process as seamless as possible.