Submit a request – MyDVASupport

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Your email address

Applicant First Name

Applicant Last Name

Applicant Date of Birth

Driver License/ID Number

Please input Applicant's DC issued Driver License or Identification Card Number

Applicant Phone Number

Enter without any dashes or spaces- Example 2021110000

Medical Practitioner Name(optional)

Medical Practitioner State(optional)

Please select the state where Medical Practitioner Practices

Medical Practitioner Identification Number(optional)

Medical Practitioner Phone Number(optional)

Enter without any dashes or spaces- Example 2021110000

Subject

Additional Information

Please provide details of your request. A member of our support staff will respond to it within 7 business days. Thank you.

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