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Glass Financial Group - Phoenix Financial Planning
602.952.1202 877.895.5012
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Forms & Documents
These Forms and Documents are provided for your use. Please feel free to print and copy them as needed.

Group Health
Employee and Family Medical Questionnaire
Group Census Form
Group Health Waiver Form
Authorization to obtain information

Basic - Human Resources information website

COBRA FORMS: If Glass Financial Group is your agent and you would like information about a “FREE” COBRA service to assist with notifications, please contact our office.

COBRA Notice
COBRA Tool Kit
Initial Notice

Individual Health
AEA Verification Form

Broker of Record Change for Blue Cross

Privacy Promise





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877.895.5012 602.952.1202 4455 E Camelback Rd, Suite 260 D, Phoenix, AZ 85018
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