Insurance Card and Driver's License Submission

Uploading a front and back copy of your insurance card and your driver's license

allows us to verify your insurance coverage prior to your first visit.

Submission

You have 2 options to send copies of the Insurance Card and Driver's License:

1) Click on the buttons below to securely upload a clear, readable photo of your PRIMARY INSURANCE card (front and back) along with your current DRIVER’S LICENSE. 

2) Scan and Email copies of these to marpearlcontactme@gmail.com

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Important: Photos/images must be in one of the following formats if uploading:  .jpg, .png, and .gif. and under 15 MB.

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Front of Insurance Card

Back of Insurance Card

Driver's License

Your content has been submitted

An error occurred. Try again or email the images. Be sure the file meets format and size requirement listed above.

Submission may take a few minutes. The above + Choose File buttons will change color for each image successfully uploaded. Page will direct to Contacts when finished.