Forms Directory

See below for a general list of forms that can be downloaded or printed. Please use the search bar or filter buttons to find a specific form. (Some forms may only be found behind your secure participant login.)

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    • Adopted or Step Child Verification Form
    • Appointment of Personal Representative Form
    • Authorization to Disclose Specific Protected Health Information (PHI)
    • Authorization to Release Medical Information
    • Benefits Registration Form
    • Blue Shield Claim Form - Provider Who Does Not Bill
    • Blue Shield/PPO International Claim Form
    • Death Beneficiary Designation Change Form
    • Dismemberment and Loss of Sight Form
    • Domestic Partner Declaration of Dependency for Tax Purposes
    • Elixir Designation of Personal Representative (English)
    • Elixir Designation of Personal Representative (Spanish)