Request for Release from FMO/Topline

As provided for in the Cigna-HealthSpring Rules of Engagement, this serves as notice of my intent to change sales hierarchies in six months. I understand that I am responsible for completing the required paperwork and providing it to my new FMO/topline agency for onboarding on or after my eligibility date.

Select the "Preview PDF" button below to view and download a copy of your completed form.

Note: If you do not wish to digitally complete the form, you may download a copy of the form here: https://lifeprofessionalsseniorsolutions.com/wp-content/uploads/2021/12/CHS-Request-for-Release-Form.pdf