Discount Medical Plan Application
Prescriptions

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Careington International Corporation, Medical - Dental Discount Plans, Frisco, TX

Member Information
* Denotes Required Field
*First Name   Initial
*Last Name   Suffix
*Address
 
*City
*State
This program may not be available in all States
*Zip Code -
*Home Phone --
Work Phone --
*E-Mail Address
*Where Did You
Hear About Us?
If other:
Marketing Code If you heard about us by mail,
please enter the marketing code referenced on the
back of the application form

  I am interested in receiving future offers for other products or
services from Careington. I understand that my information
is not shared with other companies for any purpose.
  By providing my name and contact information, I am joining as a member of Working America, the organization for working families with a proven track record of protecting good-paying jobs, defending our community services, and helping expand access to health care for all. As a Working America member, I understand that I will receive updates, including benefits, and action alerts on how I can help build a better future for working families. In addition to the no-cost prescription discount card, I understand that I'm eligible for nearly 40 other Union Plus benefits as a member of Working America.
  I have reviewed the terms and conditions.




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