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Call Four Reporting Sheet
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Call Four Reporting Sheet
Navigator Name
First
Last
Client Name
First
Last
Client Enrollment Date
MM slash DD slash YYYY
Client Phone Number
Have they thought about whether you want to keep your current plan or shop around for new coverage?
Keep current coverage
Want to shop for new coverage
Did you provide Education during this call?
Yes
No
Did they schedule an open enrollment appointment?
Yes
No
Anything else to add about the call?
Δ