Healthy Tigers Screening Form - Fill Online, Printable 2026

1. Click ‘Get Form’ to open the Healthy Tigers Screening Form in the editor.
2. Begin by filling out Section 1. Enter your name, subscriber banner number, sex, age, and date of birth. Ensure all information is accurate.
3. Provide your subscriber name as it appears on your AU BCBS insurance card along with the contract and group numbers.
4. Fill in your daytime or campus phone number and email address for contact purposes.
5. Select your race/ethnicity from the provided options to ensure comprehensive health data collection.
6. Indicate any health conditions you have or have been told you had by marking all that apply in the relevant section.
7. If applicable, list any medications you are currently taking in the optional section provided.
8. Section 2 will be completed by your healthcare provider. Ensure they fill out required data such as blood pressure, height, weight, and cholesterol levels.
9. Once completed, review all sections for accuracy before submitting the form to AUPCC using the provided contact details.

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