Enrollment Form/Change Form

When enrolling in medical or dental benefits, please download and complete the Medical & Dental Enrollment Form.  For a change of dependents, address change or employee termination, please complete the Medical and Dental Change Form.  Completed forms may either be mailed to the Diocesan House at the address  below or emailed to Susan Abington.

The Episcopal Diocese of Tennessee, 3700 Woodmont Blvd., Nashville, TN 37215