Pre-Designation of Personal Physician
Sick Benefit Form
Teamsters Benefit Trust Form
Teamsters Managed Health Care Trust Form
Send completed forms to
Teamsters Local 350
150 Executive Park Blvd, Suite 2800
San Francisco, CA 94134
Teamsters Benefit Trust
PO Box 5820
Fremont, CA 94537
Teamsters Managed Health Care Trust
PO Box 757
Pleasanton, CA 94566