test page 2 – forms to crm ACA Enrollment Appointments Lead Source -None-ObamacareForNC LeadAdvertisementCold CallExternal ReferralWeb ResearchChatMedicare Solns NCMyMedigapConsultantMyMedicareConsultant Lead Status -None-AEP – Attempted to ContactSEP – Attempted to ContactContact at AEPContactedJunk LeadDead LeadNot ContactedPre QualifiedNot qualified nowMedicare – Follow UpContacted-Follow upEnrolled First Name* Last Name* Street* Zip Code* Date of Birth* Family Size* -None-123456789 Household Income* -None-no incomeless than $11,490$11,490 to $20,000$20,001 to 40,000$40,001 to $60,000$60,001 to $80,000$80,001 or above Current Coverage* -None-thru workthru spouse’s coverageindividualnone Email* Phone* Referred by -None-FacebookMailerFriendSearch EngineMy PharmacistOther Leave a Reply Cancel replyYou must be logged in to post a comment.