Test form Signups
| Status | Active |
|---|---|
| Misc Member Notes | CASH20 RenewalCalled & requested a list of dentists be mailed to her 1/21/19 KS Member called in to say that she is mailing in a check for renewal. I let her know about delays with the post office, she said it's okay she doesn't have any dental appts soon. I explained that if we receive after expiration, it will begin the day we process it. She said she is hard of hearing and wanted me to notate that if we need to call her and LVM, to speak up. 3/1/2021 MT Marjorie called in, requested list of GP and SP near here to be mailed. (sent on 3/24/21) 03/23/21 JC Member called to complain about our reminder process for ExMails, that the check hasn't showed cleared on her bank statement, said we're very slow. I explained as best as I could. Added space in primary. 06/10/24 MT Member called in to complain (called yesterday) that we are sending too many notices for renewal when she already did. She said she got ANOTHER call to renew today and said our company is trash, we’re horrible scammy people for calling her again, blah blah blah. I added space in primary name again (did yesterday as well). EM’d Adam 06/11/24 MT Member called to see if we received her check, have not yet.//She called in again asked us to hold the check until the end of September, do not cash. She said she will call at the end of the month, 9/28/26 bc she might make it a family plan. 09/09/26 MT We got check, called, LVM to let her know we are holding the check until she reaches out, see above note.//She called in and confirmed above. 09/11/26 MT She called in and said to process check we received for ind plan. Check already made out for ind plan. 09/25/26 MT |
| Membership Type | Individual Plan ($99.95) |
| Are you renewing your plan? | Yes |
| Please enter your current membership ID# here. You can find this in your renewal email or on your current membership card. | 1757520242 |
| Your Name | Marjorie Burke |
| Phone | (352) 436-0533 |
| Date of Birth | 02/11/1956 |
| Referred by or Referral Code | Info packet Mail 4-5-16, ExMail 8-3-17, CASH20 Renewl 1/7/19, ExMail 1/6/20, ExMail 3/10/2021, ExMail 03/08/22, ExMail 04/24/23, ExMail 5/30/24, ExMail 09/10/2025, ExMail 09/25/2026 |
| Enter Office Code | A20815 |
| Address | 1089 N Chance Way INVERNESS, FL 34453 Map It |
| Payment Method | Check |
| Payment Received | Paid |
| Total | $99.95 |
| Go Green | Paperless Option | not |
| Terms |  I have read the Terms and Conditions and wish to purchase the Discount Medical Plan. |
| Plan Information | |
| Newest Membership: Programmatically pick Plan Start Date Based on either new plan or their ID number here | 10/11/2026 |
| Newest Membership: Programmatically pick Expiration Date Based on either new plan or their ID number here | 11/11/2027 |
| Membership ID Number | 1790363679 |
| Past Plan Information | this probably isn't needed there should already be additional entries |
| Resend Sign Up Email | 8 |
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