These printable forms allow you to exercise your privacy rights in the most efficient
manner. By printing, completing and sending these forms to the Privacy Office, your
request will be processed efficiently because we will have the information needed
to fulfill the request.
Arkansas Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross
and Blue Shield Association and is licensed to offer health plans in all 75 counties
of Arkansas. Copyright © 2001-2014 Arkansas Blue Cross and Blue Shield