Consumer Video - Agent Personalization

CONSUMER VIDEO PERSONALIZATION

Fill out the form to have selected videos personalized with your unique Agent Enrollment link.
This Video Personalization form is for ALL consumer videos we have available (not just the TruGap video as highlighted in the image above). Below you will be able to select all of the videos you are wanting to have personalized.
Agent Name*

First NameLast Name
Phone Number*
Email*
example@example.com
Agent Code*
Choose Video: "As-is" option is the video as you saw as-is with our information (our 800# and website address) and the Personalized Video option replaces our information with your agent information in the video including the Call-to-Action button personalized to your Unique Enrollment Link.*

Video As-is - no personalization but need the link or embed codePersonalized Video - want personalized and the link or embed code
How do you want the video (Choose the options below)*

iFrame Embed codeLink to VideoBoth
How will you use the Video (select all that apply)*

WebsiteEmailSocial Media
All vidoes are listed here. If a video is still waiting for approval from vendor or carrier and shows not available yet on the healthyamericainsurance.com website, you can select the video now from the list below and once the video becomes available, we will customize the video based on the options you chose above or if you requested the video "as-is" the link or embed code for that video will then be sent to you once we have obtained final approval from the vendor or carrier.
Choose the Videos You want (select all that apply)*

UBA Membership VideoBenefit Boost VideoLyric Health Virtual Visits - Virtual Urgent Care VideoLyric Health Virtual Visits - Virtual Talk Therapy VideoLyric Health Virtual Primary Care VideoDental Insurance VideoVSP Individual Vision Plan VideoTerm Life Insurance VideoRisk and Insurance VideoAccidents Happen VideoAccident Insurance VideoCritical Illness Insurance VideoFirst Diagnosis Critical Illness VideoTruGap Video - The Next Big ThingTruGap Video - A Reason To DanceTruGap Video - Hands Above the RestTruGap Video - Don't StressTruGap Video - Color outside the Lines
Comments or Questions
Please verify that you are human*
Should be Empty:

CONSUMER VIDEO PERSONALIZATION