Get the free employee medical blank form - usc

GROUP MEDICAL CLAIM FORM SUBMIT CLAIMS TO: P.O. BOX 45018, FRESNO, CA 93718-5018 Phone: (800) 442-7247 1. Your Policy and/or Group number(s) 2. Name and address of employer EMPLOYEE INFORMATION 3.
Fill & Sign Online, Print, Email, Fax, or Download
Get Form
  • Get Form
  • eSign
  • Fax
  • Email
  • Add Annotation
  • Share
Fill Online
Rate free





If you believe that this page should be taken down, please follow our DMCA take down process here.