Walgreens Specialty Pharmacy Enrollment Form
Who is this for?
If you have prescription drug coverage through Blue Cross Blue Shield of Michigan or Blue Care Network, use this form to order your specialty drugs through the mail.
Access the form here: Walgreens Specialty Pharmacy Enrollment Form (PDF)
What you’ll need
- Enrollee ID card
- A prescription from your doctor
- A printer to print the form
- An envelope and postage to mail the form
If you have any questions, please contact us.