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FOR AGENT USE ONLY (Please print legibly) Agency Code Agent Number Agent Name Simply Blue or Blue SM Individual Health Contract Application A Reason for Application I am a new applicant, not currently
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What is for agent use only?
For agent use only is a section on a form or document where sensitive or confidential information is to be entered that is intended only for the agent's reference.
Who is required to file for agent use only?
The individual or entity listed as the agent on the form or document is required to file for agent use only.
How to fill out for agent use only?
To fill out for agent use only, simply enter the sensitive or confidential information that is meant only for the agent's reference in the designated section.
What is the purpose of for agent use only?
The purpose of for agent use only is to protect sensitive information from being disclosed to parties that do not have the authorization to access it.
What information must be reported on for agent use only?
Any information that is considered confidential or sensitive and is meant only for the agent's reference must be reported on for agent use only.
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