12/7/23 STAR MAG Brownsville Sign Up

Step 2: Enter information as seen on your Driscoll Health Plan Card

To make sure you are registered, please review the information below as seen on your member identification card.
Member name*

First NameLast Name

Step 3: Enter Legal Authorized Representative (parent/guardian) information who will be attending the meeting

To ensure your gift card is mailed to the correct address, please enter your information below.
Legal authorized representative *

First NameLast Name
Address*
City*
State*
Zip Code*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
How did you hear about the Member Advisory Group Meeting?*

Social Media (Facebook and/or Instagram)Member EmailMember Text MessageDHP Website
Will you need Spanish translation?
For questions about the meeting or registration, please contact Julia Samaniego, Communications Coordinator at julia.samaniego@dchstx.org
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Step 2: Enter information as seen on your Driscoll Health Plan Card