FORMS

Here's where you will find the forms you may need for HPTA benefits.

 

Dental
Click here to view and/or print the dental form.


Information Update Form
Make sure we have your latest information!
Click here to view and/or print the Member Information Update form.

Mail completed form to:

HPTA Benefit Trust
PO Box 492
Hyde Park, NY 12538



These forms are in "PDF" format, which means they will open up Adobe Acrobat before you can print them. This ensures that they will print correctly. If you have any trouble, try installing the proper plugin from Adobe. Because of their size and complexity, the dental forms may take a minute or two to download to your computer. Set your printer to high resolution, and it should print better than it looks on screen.

If you have any questions, concerns or problems feel free to contact the HPTA Benefit Trust at (845) 229-2617.