Loading
             
                Get Keystone Vip Choice Otc Catalog
How it works
- 
                    Open form follow the instructions
- 
                    Easily sign the form with your finger
- 
                    Send filled & signed form or save
How to fill out the Keystone VIP Choice OTC Catalog online
Filling out the Keystone VIP Choice OTC Catalog online can help you access the over-the-counter benefits available to you. This guide provides straightforward, step-by-step instructions to ensure that you successfully complete the catalog and submit your order.
Follow the steps to complete the Keystone VIP Choice OTC Catalog
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering your date of birth in the designated field. This information helps verify your identity.
- Locate your Member ID, which can be found on your health ID card, and enter it in the appropriate section.
- Fill in your last name, first name, and middle initial (MI) to ensure accurate identification.
- Enter your street name and street number in the respective fields for your address.
- If applicable, add your apartment or suite number to ensure precise delivery.
- Provide your state, city, and zip code to complete your address details.
- Check the box if you are using a new address to indicate any changes in your location.
- Enter your email address and daytime phone number where you can be reached.
- Select the items you wish to order by filling in the item number, product name, quantity, and price for each item.
- Ensure that your total order amount does not exceed the quarterly benefit limit. The total order value should be calculated and entered in the Total order $ field.
- Review all entered information for accuracy. After verifying, you can save changes, download, print, or share the completed form to submit your order.
Complete the Keystone VIP Choice OTC Catalog online today to manage your benefits efficiently.
Fixed bridges and all other dental implants, except for mini-implants, are not covered.
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
        - 
                    In businnes since 199725+ years providing professional legal documents.
- 
                    Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
- 
                    Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.