Alberta Blue Cross - Sample form

Address update

Note: Only for Seniors Plus (Group 2009), Health Plus (Group 2008), Blue Choice (Group 3007) or Personal Choice plan (Group 2007) members

Current information


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Must be the plan member's number, including the two numbers after the dash, e.g.1234567-33

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New address


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This value is required.

This value is required.

Please enter a valid phone number.



Please enter the answer to the question above.


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