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Community Event Request Form

Maryland Physicians Care (MPC) supports several community-based health events around the state of Maryland that align with our mission statement, vision, and core values. To help streamline requests, we ask that you please submit community event requests using the form below.

Questions?

Contact Shannon Jones, MPC Community Engagement Manager
410-412-9730 | sjones@mpcmedicaid.com

Please submit the below form accurately to be considered.
  • Requestor Information

  • Event Information

  • MM slash DD slash YYYY
  • :
  • MM slash DD slash YYYY
  • Events must use the new MPC logo which will be supplied upon approval of event.
  • This field is for validation purposes and should be left unchanged.

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