IMS Application Form

Name

First NameLast Name
Birth Date

MonthDayYear
Phone Number
Format: 0000 000 0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How were you referred to us?
Desired Job Position
Resume

Cancelof
Voice Record

Cancelof
(As part of the application process, please submit a voice recording of the SAMPLE SCRIPT, along with your updated resume)

SAMPLE SCRIPT

Hi, am I speaking with [Client Name]?
Hi [Client Name], how are you today? My name is [Agent First Name] from My Senior Health Plan. I'm following up on your inquiry about Medicare coverage options.
Have you had a chance to review your Medicare coverage this year?

(Pause for response.)

I can connect you with one of our licensed Medicare specialists. They'll review your current coverage, answer your questions, and inform you of any options worth considering.
Does that sound good.
Great! I’ll connect you now—it’ll just take a moment. Please hold for me .
Training and Certifications
Employment Information

Please list two (2) recent employment.
Should be Empty: