Contact Us: (800) 405-1535
Home
Drug Assistance
FAQs
Faith-Based Healthcare Sharing Program
Home
Drug Assistance
FAQs
Faith-Based Healthcare Sharing Program
Proof of Insurance
Request Proof of Insurance
Contact Us
*
Indicates required field
Type of Proof Required
*
ID Card
Certificate of Insurance
Declaration Pages
Other
Your Name
*
First
Last
Insurance Carrier
*
Policy Number
*
Please describe what you need from us.
*
How do you want it delivered?
*
Fax
Email
Mail
Pickup In Agency
Other
Contact Email Address:
*
Contact Phone Number
*
🔒 Your information is secure.
Your private information is provided exclusively to our agency and will not be redistributed or sold to anyone else.
Submit REQUEST
(800) 405-1535
P.O Box 5084
Middle River, MD 21220
Click Here to Email Us
Request Proof of Insurance Documentation