2025 Kaiser HIPAA Authorization Form
Adopted or Step Child Verification Form
Appointment of Personal Representative Form
Authorization to Disclose Specific Protected Health Information (PHI)
Authorization to Electronically Transmit Information
Authorization to Release Medical Information
Benefits Registration Form
Blue Shield Claim Form - Provider Who Does Not Bill
Blue Shield/PPO International Claim Form
Blue Shield UCBT OTC COVID Test Reimbursement Form for Actives and Non-Medicare Retirees
Blue Shield UEBT OTC COVID Test Reimbursement Form for Actives and Non-Medicare Retirees
CA State Disability Insurance Form (EDD)