SELECT AN ITEM : SELECT AN ITEM : Employer Related Employee Related Carrier Specific Compliance Specific Shopping Benefits Other

-- WHAT IS YOUR TIME ZONE ? -- -- WHAT IS YOUR TIME ZONE ? --Hawall-Aleutian Std Time (HLN)Alaska Daylight Time (ADT)Pacific Daylight Time (PDT)Mountain Std Time (MST)Mountain Daylight Time (MDT)Central Daylight Time (CDT)Eastern Daylight Time (CDT)

-- HOW MAY WE FOLLOW-UP ? -- -- HOW MAY WE FOLLOW-UP ? --Call me immediately- ASAPCall back soon - End of WeekCall back later - Next Week-- Schedule a Date/Time --

- WHAT TIME CAN WE TALK ? - - WHAT TIME CAN WE TALK ? -MorningLunchAfternoonEveningWeekendsAs soon as possible

PREFERRED HOURS PREFERRED HOURSEarly Morning ( 6 a.m. - 8 a.m. )Mid Morning ( 8 a.m. - 10 a.m. )Late Morning ( 10 a.m. - Lunch)Any Morning Hour

PREFERRED HOURS PREFERRED HOURSEarly Afternoon ( 1 p.m. - 3 p.m. )Late Afternoon ( 3 p.m. - 5 p.m. )Any Afternoon Hour

PREFERRED HOURS PREFERRED HOURSEarly Evening ( 5 p.m. - 7 p.m. )Late Evening ( 7 p.m. - 9 p.m. )Any Evening Hour

MONTH MONTHJANUARYFEBRUARYMARCHAPRILMAYJUNEJULYAUGUSTSEPTEMBEROCTOBERNOVEMBERDECEMBER

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TIME TIME7:00 a.m.7:30 a.m.8:00 a.m.8:30 a.m.9:00 a.m.9:30 a.m.2:00 p.m.2:30 p.m.3:00 p.m.3:30 p.m.4:00 p.m.4:30 p.m.

HOW CAN WE CONTACT YOU ? HOW CAN WE CONTACT YOU ?Work PhoneMobile PhoneWork or Mobile

Contact Number : Contact Number : WORK PHONE

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Contact Number : Contact Number : MOBILE PHONE

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CONTACT NAME

CONTACT JOB TITLE

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