Registration for Adult Patients

If the identification you provide is not a Maryland driver’s license or MVA ID Card OR does not identify your current address, you must also provide two of the following documents as proof of your current Maryland address:

Note: Documents must include the applicant's name and address. Documents may not be from the same two agencies. (i.e. Two documents issued by MVA).

• MVA registration card or title • MVA change of address card​​​ • Utility, telephone or cable/satellite TV bill • Bank account statement • Property tax bill • Mortgage statement or proof of home ownership (Deed, Title, Bill of Sale) • Major credit card bill (Visa, MasterCard, Wal-Mart, Target, etc.)

• Residential rental contract (lease or rental contract between landlord and tenant which ​includes all signatures).

• Selective Service Card

• Federal, state or local government mail issued by the state of Maryland (ie. Social Security, social services)

• Car insurance policy • Paystubs (dated within 90 days)
• W-2 statements

• State of Maryland Health Insurance issued documents (ie. Medicaid, Medicare, Maryland Health Connection)

All documents must be dated within the past 90 days. ​

An electronic copy of a clear, recent photograph. We strongly recommend using a free, highly-rated passport photo app widely available for download via the App Store, Google Play Store or anywhere apps are available.

Generally, the photo should look like a driver’s license or passport photo. Specifically, it must be a clear, color photo of the patient’s unobscured face taken within the last six months to reflect the patient’s current appearance and feature a plain white or off-white background. The patient must be clothed, directly facing the camera with both eyes open and should have either a neutral facial expression or a natural smile. The patient must not be wearing a hat, head covering, sunglasses or dark glasses.

​The file must be an image file (.jpg) no larger than 3 MB in size and may not be digitally enhanced or altered in a way that changes the patient’s appearance.​