Get Camp Lejeune Family Member Program Update Form 10-10068c. This Form Is To Be Used By Camp Lejeune

The Camp Lejeune Family Member Program Update Form 10-10068c is designed to help users submit updates regarding their personal information, including address changes and health care coverage. This guide will provide clear instructions on how to effectively fill out the form online, ensuring a smooth submission process.

Follow the steps to complete the form with ease.

1. Click the ‘Get Form’ button to access the form and open it in the designated editor.
2. Fill in the family member's last name and first name in the appropriate fields.
3. Indicate whether this submission represents a change of address by checking the 'Yes' or 'No' box.
4. Provide your email address and specify your street address, including the city, state, and zip code.
5. Indicate if this is a new phone number by responding 'Yes' or 'No' and fill in the phone number along with the area code.
6. Select if this is a permanent address or temporary address by checking the respective box.
7. In the next section regarding health care coverage, indicate if this is an update by checking 'Yes' or 'No.' If 'Yes,' provide details about your previous coverage, including the name, effective date, and end date.
8. If you have additional health care coverage, list the type and include the corresponding effective and end dates.
9. Continue by providing details about any other health care coverage you may have, including Medicare, TRICARE, CHAMPVA, and Medicaid.
10. Complete the certification section by signing and dating the form, confirming the accuracy of the provided information.
11. If someone other than the applicant is signing, provide their name, mailing address, and contact information.
12. Once all fields are completed, you can save your changes, then download, print, or share the form as needed.

Complete your updates online today by filling out the Camp Lejeune Family Member Program Update Form 10-10068c.