GEHA will perform system maintenance today (September 18) from 7:30 p.m. to 9:30 p.m. Central time. Portions of this website might not be available during this time. We apologize for any inconvenience.

Request for Restriction Form

GEHA health plan, Connection Dental Plus® and/or Connection Vision® powered by EyeMed members and dependents may use this form to request restriction of their protected health information from disclosure to a specified person(s).