Complete the appropriate information below then select Submit to send this form by secured email to GEHA Customer Service.
Attachments cannot be sent using this secured form and must be sent under separate cover, which will not be secured. If you are in the United States, send attachments to firstname.lastname@example.org. If you are overseas, please send attachments to email@example.com. These email addresses are not secured, and any information you send to GEHA with them could be intercepted by another party.