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Medicare Appointment Form

No fee for Medicare consultation

Disclaimer:  Yes, I agree by signing this form, I authorize a licensed insurance sales agent from Amethyst Stone Insurance, Inc. to contact you via voice, email, or text to discuss health plans related to health care, the types of Medicare  products selected above.

Disclaimer:  This is a solicitation of insurance.  Agent is a licensed and certified representative of multiple Medicare Advantage and Prescription  Drug plans each with a Medicare contract.  Enrollment depends on contract renewal.  Contact may be made by an insurance agent or insurance company.  Not affiliated with or endorsed by any government entity or agency.  "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area.  Please contact or 1-800-MEDICARE (TTY: 1-877-486-2048 to get information on all your options."

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