Contact Us

Company Name:
Address:
City, Zip:
Phone:
Contact Person Name:
Contact Person Email:
What time is best to call?
Description of Industry:
Do you currently offer health coverage to your employees?	YesNo
If yes:
Who is your current agent?
Who is your current carrier?
When is your renewal?
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Note: Due to confidentiality issues a TeamChoice representative will contact you to see how TeamChoice can help you with your healthcare needs.

TeamChoice

3223 South Loop 289, Suite 312
Lubbock, TX 79423
806-795-5959 (main number)
800-683-3596 (toll free)
806-722-2403 (fax)