Forms Library

Forms Library

The below forms are for our historical enrollment process.

Use My Provider Enrollment Portal for all new enrollment.

Note: Use Microsoft Edge or Google Chrome to access the portal.

Use the individual checklistgroup checklist or in state, out of network checklist to find all the forms and documentation needed for each practice type and network.

Note: Return the completed form to

Note: Return these items via fax to 803-870-9997 or email them to

Note: Email the completed application with supporting documentation to

BlueCross® BlueShield® of South Carolina is an independent licensee of the Blue Cross Blue Shield Association.