I hereby authorize the First 2 Care Insurance Agency, to assist me with performing an inquiry on the My Access Florida Portal referencing my case, case/access number assigned, and or any additional insurance related questions.  This includes, but it is not limited to the performance of applying for renewals, initial applications, checking the status of an application and or creating an account on my behalf, etc.  I hereby release and hold harmless the First 2 Care Insurance Agency and any other parties involved in the release of this information from any liability or claims that may arise from the disclosure of this information. This authorization is valid from the date on this form and will remain effective until it is revoked via a written statement.