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Thank you for your interest in The DMV DC-MARYLAND-VIRGINIA Preventive Health Program.

What to bring

• Signed referral form/Faxed to: 866-611-1704 (if your insurance is paying)
• Current and active insurance card (if insured)
• Payment in form of cash, check or credit card (for self pay)
• Co-pay in the form of cash, check or credit card (if required by your insurance company)