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Please contact Karen Hodge, Management Services Specialist, at (585) 344-7566 or email the Specialist for any questions regarding forms. Please click the links below to download the appropriate forms.

• Excellus BCBS Dental Claim Form

• Excellus BCBS Medicare Eligibility Form

• Excellus BCBS Medical Claim Form

• Adult Disabled Dependent Form

• Dependent Adoption Form

To find the Excellus BCBS Protected Health Information Form (PHI) click on this link:  Excellus BCBS PHI Form, then select the Privacy Forms tab and then select Authorization Release Form.