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  • More
    • Home
    • About Sara
    • Services
    • Contact
    • Consumer FAQ
    • For Providers
    • New client forms
      • Other forms
      • Intake form - fillable
  • Home
  • About Sara
  • Services
  • Contact
  • Consumer FAQ
  • For Providers
  • New client forms
    • Other forms
    • Intake form - fillable

Other useful forms

NYS Authorization of release of health information (pdf)Download
General Authorized Representation form (pdf)Download
DFS Surprise Bill form (pdf)Download
Department of Financial Services Auth (pdf)Download
AR_NYmedicaid (pdf)Download
New intake form (pdf)Download

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NY Licensed Insurance Consultant (Life, Accident & Health) - Entity license 1742150 - All Rights Reserved.

Mount Kisco, New York 10549, United States

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