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Get Wellness Evaluation Form

Pletion. Y ou must submit this form within 180 days of your effective date to earn your Healthy Reward. T he Healthy Reward is not dependent on your specific test results or health status. For more health plan information, visit www.carefirst.com/healthyblue. You can view our Preventive Services Guidelines at www.carefirst.com/prevention. If you do not have Internet access, please call Member Services at the phone number on your HealthyBlue ID card for assistance. Member Instructions for S.

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