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Intake Form 

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Application

If you wish to fax or email your application form ,you first have to download the necessary document. Print it fill in the information and fax or email it to Medicard

Customer Service:

Toll Free Phone: 1 888 689 9876

Toll Free Fax: 1 888 689 9862

E mail: info@medicard.com

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We also accept email bank transfers.

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