Downloadable Forms

To make it as convenient as possible to have and open an HSA, you may download some of the most commonly used forms right from this site.

HSA Application
Use this form to open an HSA.

Designation of Beneficiaries
If you wish to change your designated beneficiaries to your HSA, please complete this form.

Contribution Form
Use this form to make a contribution to your account.

Withdrawal Form
Use this form to make a withdrawal from your account.

Transfer/Rollover Form
Use this form to transfer funds from an existing HSA.