Group Intake Form


  1. Download this excel spreadsheet (click here)
  2. Complete the company info at the top of the sheet
  3. Compete the employee info at the bottom of the sheet. Here is an example of how to input dependents:
    How to enter dependents
  4. Save the file and email it as an attachment to :
  5. If you don’t hear back from us soon, please follow up by calling: (727)409-3264


Thank you for your business!


Gus Bohler Insurance