Downloadable Forms for Individual Products

The easy-to-use Form Finder from Blue Cross and Blue Shield of Oklahoma is now home to over 900 forms for producers, employers and members. Form Finder is the source of truth for nearly all BCBSOK forms.

Form Finder

 

Here are some commonly used forms for conducting business with BCBSOK. The forms below are in portable document format (PDF). To view these files, you may need to install a PDF reader program. Most PDF readers are a free download. One option is Adobe® Reader®.

Current Individual Forms
Stock # / Date Enrollment Forms and Change Forms Oklahoma Form #
606465.1024 2025 Individual Paper Application Checklist N/A
606681.1124 2025 Individual Paper Application Checklist (Spanish Version) N/A
73447.1024 2025 Health Application/Change in Coverage – Use this health application for 2025 plans effective January 1, 2025. N/A
600313.1124 2025 Health Application/Change in Coverage (Spanish Version) N/A
600001.1024 2025 Dental Application/Change in Coverage – Use this dental application for 2025 plans effective January 1, 2025. N/A
600314.1124 2025 Dental Application/Change in Coverage (Spanish Version) N/A
601673.1024 2025 Individual Paper Application Overflow Page N/A
601685.1124 2025 Individual Paper Application Overflow Page (Spanish Version) N/A
Stock # / Date

Account Maintenance Forms

 Oklahoma Form #
72008.0222 Auto Bill Pay - Automatic Premium Payment Authorization Agreement N/A
600901.1018 Auto Bill Pay - Automatic Premium Payment Authorization Agreement - Spanish N/A
614380.0123 Disabled Dependent Authorization Form (for Individual Plans) – Members with an Individual health plan should use this form to request continuation of coverage on their existing policy for a dependent who is incapable of self-support because of mental or physical impairment. Mail or fax the completed form to BCBSOK (see address and fax number at the top of the form). N/A
Stock # / Date

Legal / HIPAA Forms

 Oklahoma Form #
07.01.22 Standard Authorization Form and other HIPAA Privacy Forms N/A

 

 

Last Updated: April 03, 2025