American HealthCare Holdings PreCertification Request Form

Click on the link below to access the Precertification Request Form from American Healthcare Holdings.

American Healthcare Holdings Precertification Request form

This form can be submitted two ways:

  • The form can be printed, filled in and then faxed to American Healthcare Holdings at (877) 881-9643.
  • The form can be filled in, saved and then emailed to


The form cannot be submitted on-line.  The form must be either faxed or emailed, as listed above.

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