The Health Education Referral Form should be used to refer your Members to IEHP's Wellness Programs.  Simply click on the link below to view and print the form and instructions. IEHP encourages you to submit the form electronically by logging into our website and clicking on "Health Education." If you would like additional information regarding the referral process or assistance in setting up a log-in, please contact the IEHP Provider Team at (909) 890-2054.  

 Health Education Referral Form & Instructions