Manually Add Your Clients Into Your CRM And Activate Your, Birthday, Holiday & New Enrollment Medicare Follow Up Campaigns Automatically

Enter Your Agent Info Below

✅ Agent - First Name: *

✅ Agent - Last Name: *

✅ Agent - Email Address: *

✅ Agent - NPN

Enter Your Clients Information Below

✅ Client - Full Name *

✅ Client - Email *

✅ Client - Mobile Phone *

✅ Add Date of Birth *

✅ Medicare Carrier Dropdown Options *

✅ Medicare Carrier (Manual Entry) *

✅ Add Plan Name *

✅ Select Plan Type *

✅ Enter - Effective Date Month *

NOTE: Enter 2 Digits - Example for January = 01

✅ Enter - Effective Date Day *

NOTE: Enter 2 Digits - Example for Day = 01

✅ Enter - Effective Date Year *

NOTE: Enter 4 Digits - Example for 2025 or 2026 etc.

✅ Select Application Signature Month - Name *

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