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Get Application Or Change In Coverage - Blue Cross Blue Shield Of ...

Sign the application as the Primary Applicant. If your spouse or any dependent(s) age 18 or over is also applying for coverage, have him/her personally sign the appropriate signature line. 3. If it is necessary to correct any errors, simply cross off what is incorrect and write your initials next to the correct information. 4. Please do not use correction fluid or tape. Please submit an application via one of the following methods. If submitting by mail or fax, please complete the entire appli.

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