Forms - Blue Cross Blue Shield Authorization

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Blue Cross Blue Shield Authorization (File: BLUE CROSS BLUE SHIELD AUTHORIZATION.pdf)
Date Posted: 08/31/15

Dept of Veterans Affairs Authorization (File: DEPT VETERAN AFFAIRS AUTHORIZATION.pdf)
Date Posted: 08/31/15

Detroit Medical Center Authorization (File: DETROIT MEDICAL CENTER AUTHORIZATION.pdf)
Date Posted: 10/06/15

Genesys Health System (File: GENESYS HEALTH SYSTEM.pdf)
Date Posted: 01/05/16

HealthPlus of Michigan Authorization (File: HEALTHPLUS OF MICHIGAN AUTHORIZATION.pdf)
Date Posted: 10/04/15

Henry Ford Health System Authorization (File: HENRY FORD HEALTH SYSTEM AUTHORIZATION.pdf)
Date Posted: 10/04/15

IRS 4506 - Copy of Tax Return (File: IRS 4506 - COPY OF TAX RETURN.pdf)
Date Posted: 08/31/15

IRS 4506T - Transcript of Tax Returns (File: IRS 4506T - TRANSCRIPT OF TAX RETURNS.pdf)
Date Posted: 08/31/15

Mayo Clinic Authorization (File: MAYO CLINIC AUTHORIZATION.pdf)
Date Posted: 08/31/15

Medicare Authorization (File: MEDICARE AUTHORIZATION.pdf)
Date Posted: 08/31/15

Michigan Tax Authorization (File: MICHIGAN TAX AUTHORIZATION.pdf)
Date Posted: 08/31/15

Military Medical Records Authorization (File: MILITARY MEDICAL RECORDS AUTHORIZATION.pdf)
Date Posted: 08/31/15

NPRC Military Medical Records Authorization (File: NPRC MILITARY RECORDS AUTHORIZATION.pdf)
Date Posted: 08/31/15

Rite Aid Authorization (File: RITE AID AUTHORIZATION.pdf)
Date Posted: 10/06/15

Social Security Authorization (File: SOCIAL SECURITY AUTHORIZATION.pdf)
Date Posted: 08/31/15

Sparrow Health System Authorization (File: SPARROW HEALTH SYSTEM AUTHORIZATION.pdf)
Date Posted: 10/07/15

Trinity Health Authorization (File: TRINITY HEALTH AUTHORIZATION.pdf)
Date Posted: 10/04/15

Walgreen Authorization (File: WALGREEN AUTHORIZATION.pdf)
Date Posted: 08/31/15

Walmart Authorization (File: WALMART AUTHORIZATION.pdf)
Date Posted: 08/31/15

WORKERS COMPENSATION (File: Workers Compensation.pdf)
Date Posted: 12/18/15

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