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Family & Friends

SCAN Family & Friends Program – Register Today!

All the information fields below must be completed.

SCAN Member Name
Member # or Date of Birth

Family/Friend Information
Name of Family Member/Friend
Mailing Address
CityStateZip
Phone
Email

Relationship to SCAN Member



This individual will begin receiving general SCAN member and benefits information in the mail.
Please send my family or friend literature in Spanish


SCAN will not sell or share any provided names or personal information to other companies, and no personal medical information will be provided or shared through this program.

Last updated on 11/9/2010