Potential Supplier

If you are already a Blue Cross Blue Shield supplier, you do not need to complete this survey.

1. Contact Information

2. Headquarters (HQ) Information

3. Additional Information

4. Michigan Presence: Do you have a facility in the state of Michigan?

5. What is the size of your organization?

6. Type of Organization

7. Holding Status

8. Are you affiliated with any Unions?

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