Consent Forms​

CONSUMER ENROLLMENT PACKET YOUTH
Consumer Enrollment Packet Adult
TX Plan Acknowledgement

1303 L’Enfant Square SE
Washington, DC 20020
202-269-2401

Monday – Friday 9:00 AM to 6:00 PM

1341 West Mockingbird Lane, Suite 600W
Dallas, Texas 75247
888-440-0752

Monday – Friday 9:00 AM to 3:00 PM

6340 Security Boulevard, Suite 100 Baltimore, MD 21207
202-269-2401

Monday – Friday 9:00 AM to 6:00 PM

7322 Southwest Frwy
Suite 806 Houston, TX 77074
888-440-0752

Monday – Friday 9:00 AM to 3:00 PM