-7 If "No", the name of the "Responsible Party" must match exactly what Peach State has on file for "Responsible Party" or change cannot be processed. Directions: Please fax Member Data Change forms, with a copy of the member ID card, if available, to Peach State Member Services Department at 1-800-659-7518. If you have questions about how to complete this form please call the Member Services Department at 1-800-704-1484.