Patient Document Submission Instructions
Please read the following instructions carefully and complete all required steps before submitting your paperwork. Incomplete submissions may result in delays in scheduling your appointment and care.
Required Documents for Appointment Scheduling
State-Issued ID or Driver’s License – Front:
Submit a clear copy of the front of a valid state-issued ID or driver’s license.
For minors (under 18): A parent or legal guardian must submit a copy of their valid state-issued ID or driver’s license.
Insurance Card(s) – Front & Back:
Submit a copy of the front and back of your active insurance card(s).
For minors (under 18): A parent or legal guardian must submit a copy of the sponsor's active insurance card(s).
Submission options:
Patient portal: Send as an attachment through the secured links sent to you via the Tebra patient portal by email or text
Fax: 949-543-2361
Important Notes
Complete All Forms:
Please ensure all required documents are fully completed no later than 24 hours before your scheduled appointment to avoid cancellation.
Incomplete submissions will not be processed, and appointments are subject to cancellation
Insurance Verification:
Failure to upload or provide insurance details before your appointment may result in being charged the full out-of-pocket rate for services.
For Minors (Under 18):
A Consent to Treat a Minor form must be completed (found on the last page of the required forms).
Contact Information
If you have any questions, please contact our office:
DMV Medical Group
10421 Motor City Dr. Ste. 341334
Bethesda, MD 20817
Phone: 240-669-7496
Fax: 949-543-2361
Email: info@dmvmedgroup.com
Thank you for your cooperation. We look forward to assisting you with your healthcare needs.
Property of DMV Medical Group, LLC, 2026 (c)