MetLife Forms
	MetLife Application EE 2-9 Lives 3 Pages (Rev. 11-08)
	MetLife Dental HMO Enrollment Form-CA Benefits provided by SafeGuard Health Plans, Inc., a MetLife company, 1 Page (Rev. 4-09)
	MetLife Domestic Partner Declaration 2 Pages (Rev. 4-09)
	MetLife HIPAA Request Form If you wish to include in your booklet certificate the HIPAA privacy language, complete this form., 1 Page
	MetLife Language Assistance Preference Notice 1 Page (Rev. 9-08)
	MetLife Privacy Notice This notice explains how MetLife protects your privacy and treats your personal information., 2 Pages (Rev. 2009)
	MetLink User Authorization Form MetLink puts simplified administrative tools, including enrollment services, claims status and billing access, at your fingertips. , 2 Pages (Rev. 6-10)
	Statement of Dependent Eligibility Beyond Limiting Age 4 Pages (Rev. 2-10)

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For additional information, please contact Claremont at 800.696.4543 or info@claremontcompanies.com