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Specialty Forms

  • Center for Pregnancy Form – Providers can use this form to apply for participation in the Centering Pregnancy Program. Providers must have Centering Healthcare Institute membership and also be in the process of achieving Site Approval status. The Centering Healthcare Institute is a separate company that provides wellness education on behalf of BlueCross BlueShield of South Carolina. 
  • Maternity Screening Referral Tool (SBIRT) – Providers can use this universal tool to identify pregnant women who need help with behavioral and problematic issues and refer them to treatment. 
  • Pregnancy Notification Form – Complete this form to ensure members receive support early during pregnancy. 
  • Radiation Therapy Treatment Form – Complete this form to notify BlueCross about radiation treatment for transition cases. 

Other Forms

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