All information is confidential.
	No unsolicited emailings.
	First Name:		Creative Health Insurance
	Last Name:		230 Hartford Turnpike
	Street Address		Vernon, CT. 06066
	Town
	Zip code		Local Phone . . 860-647-7353
	Phone Number:		Toll Free . . . 1-866-508-0618
	Best Time to Call:		Fax . . . . . . . . . . 860-896-7440
	E-Mail address:		Email: Creative-Health@comcast.net
Type any comments or questions here:
			Robin Dubord
			Office Manager
	If you are a Medicare beneficiary, by submitting this form, your are giving Creative Health Insurance permission to make contact with you for the express purpose of discussing Medicare Advantage plans, Medicare Supplemental plans, Part D Drug plans. This is to protect you from receiving information on products you did not authorize.
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	JA September 24, 2010