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Online Forms

Click on a form from the list below to download

How to use your AmeriFlex Convenience Card®

AmeriFlex Convenience Card® Online Instructions

Why use the AmeriFlex Convenience Card®

AmeriFlex Convenience Card® Savings Model

Enrollment Form
     click here for Spanish

Claim Form
    click here for Spanish

Direct Deposit Form

FSA Enrollment Kit
      click here for Spanish

FSA Eligible Expenses

FSA Quick Reference Guide
     click here for Spanish

CRA Quick Reference Guide

CRA Change Form

POP Quick Reference Guide
     click here for Spanish

HRA Participation Agreement

HRA Activation Form

Employee Request for Service

Substantiation Request Form