I don't have diabetes, but filled out the info to see if I receive anything in the mail
Personal Information
An asterisk (*) designates a required field for enrollment.
First Name * Last Name * Date Of Birth
/ /
Address * City * State * Zip *
Phone Number Email Address Type of Insurance
- - Select Type Medicaid Medicare Other Insurance I do not have Insurance
Yes, you may contact me by phone in order to complete my enrollment. * This serves as my written consent that a representative from NationsHealth can contact me by phone.
Best time to call:
Morning Afternoon Evening Weekends
Yes, I am interested in joining the NationsHealth family. *
(Check all that apply)
Diabetes Supplies Moist Heating Pads Prescription Medication
Ostomy Products Impotence Devices Wound Care Supplies
Personal Information
An asterisk (*) designates a required field for enrollment.
First Name * Last Name * Date Of Birth
/ /
Address * City * State * Zip *
Phone Number Email Address Type of Insurance
- - Select Type Medicaid Medicare Other Insurance I do not have Insurance
Yes, you may contact me by phone in order to complete my enrollment. * This serves as my written consent that a representative from NationsHealth can contact me by phone.
Best time to call:
Morning Afternoon Evening Weekends
Yes, I am interested in joining the NationsHealth family. *
(Check all that apply)
Diabetes Supplies Moist Heating Pads Prescription Medication
Ostomy Products Impotence Devices Wound Care Supplies
Click here to visit:
Disclaimer: http://investorshub.advfn.com/boards/irp.aspx?userid=65709
Join the InvestorsHub Community
Register for free to join our community of investors and share your ideas. You will also get access to streaming quotes, interactive charts, trades, portfolio, live options flow and more tools.
