To receive a free health insurance quote, please complete one of the following census reports. For your convenience, two file formats, an Excel spreadsheet and a PDF file, have been provided. Please fax the completed form to (866) 539-2520 or you may email it to Jimmy Cathey with "Quote" as the subject. Either form may be used. For questions, please call Jimmy Cathey at
(214) 630-3751.

Insurance Quote Form (Excel File)

Insurance Quote Form (PDF File)