Click Here for CareFirst BlueCross BlueShield RSV, Flu and COVID Vaccine Updates

Medicare Advantage Sales Event Form

CareFirst must be notified of all sales events 14 business days prior to the scheduled event.

*Required

Name of FMO*

Agent's First Name*

Agent's Last Name*

Phone Number

Email*

Agent NPN*

Name of Agent presenting if different from above

Presenting Agent NPN

Event Information

Date of Event*

Event Start Time*

Event End Time*

If hosting a live event

Venue Name*

Venue Type*

Venue Address*

Venue Phone Number*

If hosting a webinar

Webinar invitation details*

Number of people invited

Capacity

Briefly describe what product(s) will be discussed at the event*

Will you need extra support from CareFirst BCBS to manage event?

If yes, select the support you’ll need (check all that apply):

Sales Materials
Product-branded Giveaways
Virtual Event Support
Other

Please complete all required fields and submit.