Forms

The following forms are available for you to download and print. You will need Adobe Reader to view these documents.

You may obtain a Medical Claim Form from your provider or facility.

Medical Claim Form

Dental Claim Form Front Page
Dental Claim Form Back Page

COB Update Form

Subrogation Form

 

For further information, please contact American Group Administrators.
Our New York office can be reached at (800) 826-5722 from 9:00AM to 5:00PM Eastern.
Our Las Vegas office can be reached at (800) 842-4742 from 7:00AM to 4:30PM Pacific.