By clicking “"Book" or "Submit” you acknowledge and agree that (1) our Privacy Policy and Terms & Conditions of Use in your use of our services (including that any dispute between you and Seek Insurance Services, Inc. (and its affiliates, successors, and assigns) shall be submitted to and resolved by individual arbitration rather in a court and (2) Seek Insurance Services, Inc. (and its affiliates, successors, and assigns) may contact and send you information to help you decide which Medicare insurance plan is best for you as well as provide you with other information and marketing materials regarding Seek Medicare and its insurance and other services via recurring text messages or prerecorded or artificial voice messages using an “automated telephone dialing system” or “autodialer” to the contact information you provided, even if the phone number you provided is on a federal or state Do Not Call List. Your consent to receive communications from Seek Insurance Services, Inc. is not a condition of purchasing a service or product from or through us, and you may revoke your consent by using the opt-out method contained in the communication or by emailing us at privacy@seekmedicare.com, or calling (833) 364-0074 or 711 for TTY service. Message and data rates from your mobile carrier may apply.
If you are a California resident and you would like to make an Access/Data Portability, Deletion Request, or Do Not Sell Request, please call us at 844-955-3690 or 711 for TTY service, or send an email to compliance@seekmedicare.com with "California Consumer Request" in the subject line and please include the nature of your request.
The government also requires us to put this text here:
The Centers for Medicare & Medicaid Services (CMS) requires documentation of the scope of an appointment prior to meeting with a Medicare beneficiary.
When you complete the appointment booking form, you may select the plan types you wish to discuss with the SeekMedicare Agent. You may uncheck any of the plan types you do not wish to discuss.
By electronically signing this form, you are agreeing to speak or electronically interact with a licensed agent associated with SeekMedicare to discuss the specific product types listed above. SeekMedicare's Agents will discuss any plan that may be a fit with you. SeekMedicare's Licensed Agents are also contracted with one or multiple Medicare plans to discuss their Medicare product and receive compensation if you enroll in a plan with which they are contracted. The SeekMedicare Licensed Agent does not work directly for the federal government.
Electronically signing this form does NOT obligate you to enroll in a plan and will not result in your automatic enrollment. You will only be enrolled in a plan with your explicit consent and direction.
Also, electronically signing this agreement will NOT affect your current or future Medicare enrollment status.
By submitting this form, you consent to receive calls or electronic contact (at the number/email/other contact information that you provide above) from a SeekMedicare Agent about the Medicare products that you have marked.
