Forms for Our Members

For assistance with member services forms, please contact our Help Desk at 800.460.8988.

US Script Printable Forms:

• Claim Form (PDF file) (English)     (Spanish)

Member Handbook for Commercial Plans:

• Member Handbook for Commercial Plans (PDF file)

Grievance and Appeals:

• Grievance and Appeals (PDF file)

USS Prior Authorization Form:

• USS Prior Authorization Form (PDF file)

Use Acrobat Reader to view the files. If you do not have one, you could download it for free at Adobe Acrobat website.