test page 2 – forms to crm ACA Enrollment AppointmentsLead Source-None-ObamacareForNC LeadAdvertisementCold CallExternal ReferralWeb ResearchChatMedicare Solns NCMyMedigapConsultantMyMedicareConsultantLead Status-None-AEP – Attempted to ContactSEP – Attempted to ContactContact at AEPContactedJunk LeadDead LeadNot ContactedPre QualifiedNot qualified nowMedicare – Follow UpContacted-Follow upEnrolledFirst Name*Last Name*Street*Zip Code*Date of Birth*Family Size*-None-123456789Household 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 aboveCurrent Coverage*-None-thru workthru spouse’s coverageindividualnoneEmail*Phone*Referred by-None-FacebookMailerFriendSearch EngineMy PharmacistOther
