Forms


	BCBS - Ohio (File: BCBS - Ohio.pdf) Date Posted: 08/31/26

	BCBS - Tennessee (File: BCBS - Tennessee.pdf) Date Posted: 08/31/26

	BCBS - Texas (File: BCBS - Texas.pdf) Date Posted: 08/31/26

	BCBS Anthem - GA (File: BCBS Anthem - GA.pdf) Date Posted: 08/31/26

	Beacon Health System - Authorization (File: Beacon Health System - Authorization.pdf) Date Posted: 08/31/26

	Blue Cross Blue Shield Blue Care Network of Michigan - Authorization (File: Blue Cross Blue Shield Blue Care Network of Michigan - Authorization.pdf) Date Posted: 08/31/26

	Bronson Authorization (File: Bronson Authorization.pdf) Date Posted: 08/31/26

	Canada Pension Plan - Authorization (File: Canada Pension Plan - Authorization.pdf) Date Posted: 08/31/26

	CENTERWELL PHARMACY (File: CENTERWELL PHARMACY.pdf) Date Posted: 08/31/26

	Children's National - Authorization (File: Children's National - Authorization.pdf) Date Posted: 08/31/26

	Children's Special Health Care Services Lansing - Authorization (File: Children's Special Health Care Services Lansing - Authorization.pdf) Date Posted: 08/31/26

	CIGNA Group, The - Authorization (File: CIGNA Group, The - Authorization.pdf) Date Posted: 08/31/26

	City of Waukesha Fire and EMS (File: City of Waukesha Fire and EMS.pdf) Date Posted: 08/31/26

	CLEVELAND CLINIC - Medical - AUTHORIZATION (File: CLEVELAND CLINIC - Medical - AUTHORIZATION.pdf) Date Posted: 08/31/26

	CLEVELAND CLINIC - Radiology - AUTHORIZATION (File: CLEVELAND CLINIC - Radiology - AUTHORIZATION.pdf) Date Posted: 08/31/26

	Community Mental Health Authorities of Clinton, Easton, Ingham Counties (File: Community Mental Health Authorities of Clinton, Easton, Ingham Counties - Auth.pdf) Date Posted: 10/08/26

	Corewell Health - Authorization (File: Corewell Health - Authorization.pdf) Date Posted: 08/31/26

	Costco Optical (File: Costco Optical.pdf) Date Posted: 08/31/26

	Costco Wholesale Hearing Aid Center (File: Costco Wholesale Hearing Aid Center.pdf) Date Posted: 08/31/26

	Costco Wholesale Pharmacy (File: Costco Wholesale Pharmacy.pdf) Date Posted: 08/31/26

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Legal-Ease Digital Imaging, LLC, 2496 Meadowcroft Dr. Burton 48519 | Phone: 855-534-4003 / 810-234-7799 | Fax: 810-547-4030