These HCFA forms conveniently fit any standard laser and inkjet printer for easy completion. If you have trouble finalizing your 1500 claim form, simply scan the new version's QR code in the top left corner to instantly access the National Uniform Claim Committee (NUCC) website and instruction manual. Save yourself time by selecting "Personalization" – we'll fill in all your primary information, so you don't have to.

If you would like this form personalized, please select 1/0 in the "Personalization" option group and provide an artwork file of your personalized 1500 form (if accessible).
** If inaccessible, our customer service team will reach out to obtain your primary information shortly after you place your order.

If "None" is selected in this option group, it will come in its stock form. 

Notable Form Features:
- New version 02/12 (approved OMB-0938-1197)
- 1 or 2 part, red ink
- Front & back printing on a full page (8.5" x 11")
- NUCC QR code
- Fits all standard laser & inkjet printers
- Stock or Personalized