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Consent Form

 

To comply with the Centers for Medicare and Medicaid Services (CMS) guidelines  for information gathering and privacy, established on June 18th 2023, we must ask that you fill out and submit this Consumer Consent Form prior to the us being able to search and provide any further information specifically pertaining to the marketplace and government sponsored subsidies that you may qualify for.

This not only includes searching on your behalf but being able to file a new or make changes to an existing application.

Compliance and privacy is our top priority.

Thank you for your understanding.

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Personally Identifiable Information (P.I.I.)
Consumer Consent Form

Ready to proceed?

Follow the 2 step process for Digital Signature

Sample of the PII Consumer Consent Form

Sample

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