Thank you for applying for health insurance with Parks Insurance Agency.

In order to complete the application for enrollment, you will need to call our phone team at 839-500-2505 to give verbal consent. This should take less than 5 minutes. If you do not call in, three attempts will be made to reach you on the contact information you provided on the application. IN BOLD or highlight (If no contact can be made, you will NOT be enrolled for insurance.)

On the following page, you will be able to enter your sensitive information that is required for enrollment: this is the HIPAA compliant way to provide the information. If you are not comfortable doing this, we can take it over the phone when you call in.