HealthSelect - Primary Care Physician (PCP) Selection Form

Primary Care Physician (PCP) Selection Form

You can either complete the GBP Supplement Form to select or change your PCP or call BCBSTX Customer Service at (800) 252-8039. Your selection will be effective the day you call BCBSTX Customer Service or the date you sign your form.

Please send completed PCP Forms to:

BCBSTX
Membership/Group Accounts
PO Box 655730
Dallas, TX 75265-5730

GBP Supplemental Form for Active Employees (63kB)
GBP Supplemental Form for Retired Employees (73kB)

If you need assistance with completing this form, please contact BCBSTX Customer Service at (800) 252-8039.

New employees: Please wait until 30 days prior to your effective date to send GBP Forms.

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