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Forms

Informal Application

An informal application includes a HIPPA compliant authorization for release of medical records. The informal application process allows underwriters to review your clients medical history informally so you can be sure how to proceed.

Informal Application

(Short Version)

Policy Authorization

Use this form to request inforce policy information or illustrations when you are not the writing/servicing agent of the contract.

Change of Agent Request

Use this form to request a change/addition of servicing agent on an existing insurance policy.