Forms Directory

See below for a general list of forms that can be downloaded or printed. Please use the filter buttons to help search for a specific form by category. Some forms may only be found behind your secure participant login. Click the blue "Showing __ Results" text at the top of the directory to see more forms.

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  • UEBT Active Premier Enrollment Packet
  • UEBT Active Ultra Enrollment Packet
  • UEBT Active Annual Verification Enrollment Packet
  • UEBT Active Other Insurance Information (OII) Form
  • Adopted or Step Child Verification Form
  • Appointment of Personal Representative Form
  • Authorization to Release Medical Information
  • Benefits Registration Form
  • Blue Shield UEBT OTC COVID Test Reimbursement Form for Actives and Non-Medicare Retirees
  • Blue Shield UCBT OTC COVID Test Reimbursement Form for Actives and Non-Medicare Retirees
  • UCBT Active Premier Enrollment Packet
  • UCBT Active Standard Clerk's Helper Enrollment Packet