GEHA will perform system maintenance on Sunday (January 20) from 4-6 p.m. Eastern 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).