RH&A

Robert Hensley & Associates, LLC

Insurance and Financial Services   

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FORMS FOR DOWNLOAD

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[forms]

Aetna

  • Enrollment Form
  • Family Health Statement
  • Waiver Form
  • Mail Order Rx Form
[forms]

Anthem

  • Enrollment/Member Change Form
  • Mail Order Rx Form
  • Renewal Certification Statement
  • Termination Form
  • Waiver Form
  • Family Health Statement
[forms]

CBIA

  • Enrollment Form
  • Family Health Statement
  • Request For Premium Refund
  • Waiver Form
[forms]

ConnectiCare

  • Enrollment Form
  • Family Health Statement
  • Waiver Form
  • Renewal Certification
[forms]

United Healthcare

  • Oxford Information Change Form
  • Oxford Mail Order Rx Form
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Robert S. Hensley, Joseph F. Shiman, III and Jill A. Brandon are registered representatives and financial planners of Tower Square Securities, Inc., a broker/dealer
(member NASD/SIPC) and a Registered investment Adviser (RIA). Robert S. Hensley LLC is not a broker/dealer or RIA and is a separate entity from Tower Square Securities, Inc.