Forms Menu

For your convenience, all of the claims forms are located here and are available to download.

Acclaim Health Insurance Claim Form

Acclaim Dental Form

Accident or Injury Claim Form

Other Insurance Coverage Request Form

Acclaim Contact Information

Your thoughts and opinions are very important to us and we want to hear from you. You may contact us the following ways:

Phone: 1-800-317-2324

Fax: (662) 377-2823

Physical Address: 808 Varsity Drive, Tupelo, Miss 38801

Electronically: Contact Us