Customer Questionnaire
Medicare can be confusing, which is why NBFS is here. We want to make your process is simple, easy and productive. Our goal is to get you the very best plan for your specific needs, saving you as much money as possible: both in premiums and out-of-pocket expenses. By taking our questionnaire, we will be able to get back to you with the information you seek, saving you time and making it a pleasant experience.

Please provide your information below. Know that your privacy is our absolute concern and we do not share your information with anyone not affiliated with NBFS, and only to provide you with the very best service possible. Also, it will allow you to receive a copy of this questionnaire, so when we speak with you, you remember the questions and answers you provided.

Thank you for the opportunity to be of service!


Your email address:

Your name:

Phone: