Covell Consultants Medicare 101 - May 14th @ 3pm

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* 1. This survey is to RSVP for the event in-office. If you plan to attend via zoom, please exit this survey and use our Zoom Link.

If you have trouble submitting this survey, please call us at 505-232-8302 and we can gather your information over the phone.

I plan to attend in person.

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* 2. Please enter your first and last name.

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* 3. Please enter your phone number.

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* 4. How would you like to receive additional information about this event?

Phone call

Text

Email

Include email address if applicable.

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* 5. We would love for you to bring guests, but we have limited space at our office. Please fill out this survey again for each person you would like to bring! This helps us get an accurate head count.

It will just be me!

I'll fill out another RSVP for each of my friends!