Mail the completed form, along with your payment, to:

        Insurance Services of America
        1757 E. Baseline Road, Ste. 126
        Gilbert, AZ  85233

If paying by credit card, you may fax your application to (480) 821-9297 or E-mail it to health@immigrationhealth.com

Within 5 business days of receipt of your Application, Insurance Services of America will inform you as to the acceptance of your application and your effective date, or of any additional information required to continue considering your application.

Remember, your Application will become a permanent part of your record, and will become a part of your certificate of coverage. Answer each question thoroughly and legibly, and attach additional sheets if necessary. If your application is not accepted, the Underwriters will promptly refund your premium. If your application is accepted, you will receive a fulfillment kit containing your certificate of coverage, an identification card, a claim form, and instructions on how to use your insurance.