Appointment Request

AHI is here to serve the community — in-person, at no charge.  We can help you navigate the health insurance enrollment process, answer questions, or even provide trainings to your community.

Please submit your contact and non-medical information and an EASE representative will respond. Or call toll-free 1-866-872-3740.

Note: Content submitted via this form is received by an administrative department and checked only during normal business hours. Please do not share personal medical information.

  • This field is for validation purposes and should be left unchanged.

This form is not intended for sharing medical information.

What to bring to your appointment

See enrollment documents for the list of documents to bring to your appointment.