Get How To Join This Free Program Totally Linking Joining Tlc-md - Dchweb

Joining the Totally Linking Care in Maryland (TLC-MD) program is a straightforward process that allows users to access coordinated healthcare services. This guide provides step-by-step instructions to assist you in completing the online form accurately.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to obtain the form and open it for editing.
2. Enter today’s date in the designated field. This helps document when you are signing up for the program.
3. Fill in your name accurately as it should appear on official documents.
4. Provide your signature in the specified area to authenticate your application.
5. Input your complete address, including street, city, state, and zip code.
6. Fill in your phone number, ensuring it is a reliable contact number.
7. Enter your email address for electronic communications regarding your enrollment.
8. Provide the name of a witness who can verify this application.
9. Have the witness sign the form in the designated area.
10. Choose your patient consent by checking one of the options: ‘I want to enroll’ or ‘I do not want to enroll’.
11. Review all the filled information for accuracy and completeness.
12. Once you are satisfied with the information, save your changes. You may also choose to download, print, or share the form as necessary.

Complete your application online today to take the first step towards improved healthcare coordination.