Int’l Group Health Pg 2 of 2: For Group Health Insurance Quotes, we'll need to get a better idea of your group, your goals and census form. You can use this form to introduce yourself and gain access to our "Get started" page, please tell us a bit more about yourself. (You can also Skype us at 'goodneighborinsurance' or speak with us at 480-813-9100 or toll-free 866-636-9100 with any questions you may have!) Can you tell us ... ?First NameLast NameEmail* Organization name*Job TitleWould you like us to call you? (xxx)xxx-xxxxInterested in:Group InsurancePartially self-insuredSelf-fundedWhichever option is bestSize of group?Number of overseas staff you want coverage for?Countries they are living in? Renewal DateAny additional Comments or Questions?We send out a quarterly helpful, money-saving e-bulletin, as well as updates, to keep you up-to-date regarding changes to policies, explain new benefits, as well as help you save money and stay safe while traveling. If you do not wish to receive our quarterly newsletter, you can say so here, or you can wait and unsubscribe at any time by using the link provided at the bottom of each newsletter. Rest assured - We never share or sell our lists. Ever.Get the e-Bulletin 4X a year!YesNoLastly, how did you hear about us?We're open 8:00-17:00 MST Monday-Friday. On work days we provide quotes within 24 hours, and usually much sooner than that. If your request is submitted over the weekend, we will get a quote to you before the end of the work day on Monday.EmailThis field is for validation purposes and should be left unchanged.