Sponsorship Request Form

This form is used to request that Molina Healthcare of South Carolina sponsor your:

Upcoming event

Campaign/Initiative

Corporate/Statewide sponsorship

Yes No

* Denotes Required Fields.

Volunteer Opportunities

Submitted Successfully

Please complete required questions and resubmit
Please enter a 10 digit telephone number
Please enter a valid Zip code


Please submit any additional documents to SCSponsorshipRequest@MolinaHealthcare.com. In approximately 4 weeks, you will receive a reply to your request.


By submitting my information via this form, I consent to having Molina Healthcare collect my personal information. I understand and agree that my information will be used and shared in accordance with Molina Healthcare's Privacy Policy and Terms of Use.

You may have to pay for services that are not covered. You may also have to pay for services from providers not part of our network. If the services were an emergency, you don’t have to pay. If you need help, call Member Services.