Notice of Your Rights About Health Insurance
Arizona · Arizona Judicial Branch
This form is a notice that informs people about their rights regarding health insurance.
Where this fits in a case
General & infoInformation / general use — not tied to one step of a case
This form is associated with a Summary Consent Decree in a family law matter.
Either party may file.
Official instructions
How-to guides published by the court for this form.
- Instructions: How to Fill Out the Consent Decree for Dissolution of Marriage (Divorce) or Legal Separation in a Non-Covenant Marriage - With or Without Children
- Family Court / Sensitive Data Cover Sheet With Children (Confidential Record)
- Family Court / Sensitive Data Cover Sheet Without Children (Confidential Record)
- Instructions: How to Complete a Child Support Order
- Parenting Plan Information
Common questions
- What is this form for?
- This form is a Notice of Your Rights About Health Insurance.
- Who should fill this out?
- The metadata indicates this form is related to a Summary Consent Decree.
Revision history
No changes recorded since we started tracking this form on October 10, 2026.
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