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Individual Enrollment Request Form 3800 Kilroy Airport Way, Suite 100 Long Beach, CA 90806Please contact SCAN Health Plan if you need information in another language or format (Braille). To enroll
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Enrollment forms - scan are electronic forms used to register for a program, service, or activity by scanning a barcode or QR code.
Any individual or organization looking to register for a program, service, or activity that offers enrollment forms - scan.
To fill out enrollment forms - scan, simply scan the barcode or QR code using a smartphone or scanner, and enter the required information accurately.
The purpose of enrollment forms - scan is to streamline the registration process and make it more convenient for both the registrant and the organization offering the program.
Enrollment forms - scan typically require personal information such as name, address, contact details, and any specific information relevant to the program being registered for.
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