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Please fill out the information below if you have questions about the Baby Blocks program.

For questions about your UnitedHealthcare benefits or membership information, please call the telephone number on the back of your member ID card.

Fields with an asterisk are required.

Email Format: example@example.com

Please click here to view where the Member ID is located on your insurance card.

Date Format MM/DD/YYYY

Mobile Number must be 10 digits and without dashes (9999999999)

Date Format MM/DD/YYYY

Date Format MM/DD/YYYY

Date Format MM/DD/YYYY

Date Format MM/DD/YYYY

Date Format MM/DD/YYYY

Date Format MM/DD/YYYY

Date Format MM/DD/YYYY

Date Format MM/DD/YYYY

Date Format MM/DD/YYYY

Did your child receive shots during this visit?



Date Format MM/DD/YYYY