Sales Event Template by moneu

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									           Attachment 1: Group Sales Presentation Data Template
                                                     The excel spreadsheet below is the CMS approved reporting format. Please submit by the 15th of each month.
                                                   Please download, complete and e-mail or fax back (select one method) to SecureHorizons at the following addresses:
                                                                                          E-mail: mbx_brkrsupport@phs.com
                                                                                                or Fax: (714) 825-5309
- Organization Name: SecureHorizons® by UnitedHealthcare
CMS Contract Number(s) of Plan(s) To Be Sold:




Date:    Time           Name of      Venue Name                     Description of Venue        Venue Phone Venue Street         Venue City Venue         Venue Zip
mm/dd/yy                Brokerage                                   (e.g., sales event at       Number      Address                         State         Code
                        Firm/                                       senior center, health fair)                                                                         Event     Contact
                        Agency/Sales                                                                                                                                    Contact   Phone        Contact e-mail
                        Associate                                                                                                                                       Person    Number       Address
Example:                                                            Sales Event-Meeting
                                                                    Sales Event-Senior Center
07/02/07    08:00 AM    ABC Agency     Starbux Coffee-Secure, SH    Sales Event-Restaurant      888/555-5105 38 Secure Lane      Secure      SH           00000         Best Agent 888/555-5105 bestagent@secure.com
                                                                    Sales Event-Health Fair

								
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