CareFirst Health Health Program | Care Management Assessment

Verify your information

Let’s begin by verifying your information to help ensure your answers are linked securely to your health record.

Step 1: Personal Information
First Name*
Last Name*
Date of Birth*

MonthDayYear
Zip Code

Street Address

Street Address Line 2

CityState / Province

(Home Address)

Step 2: Patient Identification
If you have the Personal Access Code from your CareFirst letter, you can enter it below.
Personal Access Code*
Typically included in your welcome letter/email
CareFirst Member ID*
May be called a Subscriber Number or Patient ID

Step 3: Additional Contact Details
Phone Number
Phone Type
Email
Verify your information using your mobile number
Opt-in to communication by phone

YesNo
Opt-in to communication by email

YesNo
Note: Providing your email or phone number is optional, but it may help us confirm your identity and share program opportunities with you.
Questionnaire Url*
Questionnaire Url*
Questionnaire Version*