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Tom Storm Insurance Agency, Inc.
10327 Grand River Rd. Suite 402
Brighton, MI 48116		   Google Maps
 
Phone:  810-588-6310
Fax:  800-550-1785
Email:  karen@tomstorminsurance.com

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Medicare Questionnaire

Tom Storm Insurance Agency, Inc.
We would like to provide you with more information on Medicare. Please provide as much information possible and we will contact you within one to two business days to discuss the Medicare plan right for you. This information will be kept confidential and will be used for consultation purposes only.

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By filling this out, you agree that an authorized representative or licensed insurance agent from Tom Storm Insurance Agency, Inc. may contact you by phone or email to answer your questions or provide additional information on Medicare Advantage, Medicare Supplement or Part D plans.

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Tom Storm Insurance Agency, Inc.
Tom Storm Insurance Agency, Inc.
Tom Storm Insurance Agency, Inc.
Tom Storm Insurance Agency, Inc.
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Important Note: This website provides only a simplified description of coverages and is not a statement of contract. Coverage may not apply in all states.
For complete details of coverages, conditions, limits and losses not covered, be sure to read the policy, including all endorsements.