Request Lead Lists PhoneThis field is for validation purposes and should be left unchanged.First Name(Required)Last Name(Required)Email(Required) Phone(Required)What type of list are you looking for?(Required) General Medicare Leads T65 Leads I'll provide my own Other Other Type of List(Required)What method of contact are you looking for?(Required) Phone Call List Post Cards Tear-away BoB Mailer Other Other Type of List(Required)What income range are you targeting? (Measured annually, and you can select multiple.) $15k-$30k $30k-$60k $60k-$100k $100k+ What State?(Required)What Counties?(Required)For T65- What birthday months? We generally recommend 5-8 months out.(Required)Ex: Turning 65 in August-DecemberIf you have specific zip codes, please copy and paste them below. If you do not, please enter 'none'.This field is hidden when viewing the formIF MAIL OR LETTER- Do you need us to design your creative piece? Yes, MCC will need to design my mailers No, I will provide my own (subject to compliance review prior to send) N/A- Phone List This field is hidden when viewing the formAdd any notes that may help complete your order.(Required)I acknowledge that lead and mailer lists are not refundable by the lead vendor, and co-op is not guaranteed. I understand that these lists are not approved for email or text message contact. I understand that I cannot target dual income beneficiaries for cold calling. Co-op'd lists are partially owned by MCC Brokerage. I understand that it may take up to a week for lead lists to be delivered, and up to 15 business days for mailers to be delivered. Noncompliant artworks will not be approved for mail send.(Required) I understand and agree CAPTCHAThis field is hidden when viewing the formSignature Δ
