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NOTE: By clicking the Submit button, I expressly consent by electronic signature to receive communications via phone, email or by text message from J. Berg & Associates, Inc. and partner companies or their agents at the telephone number I submit (even if my number is currently listed on any state, federal, local, or corporate Do Not Call list), including my wireless number, if provided. Carrier message and data rates may apply. I understand that my consent is not required as a condition of purchasing any goods or services and that I may revoke my consent at any time. I also acknowledge that I have read and agree to the Privacy Policy and Terms & Conditions. This is a solicitation for insurance and I understand by providing my phone number and information and clicking Submit, I am giving permission to contact me for the purpose of marketing insurance products and services. I also understand I may be contacted by a properly licensed insurance agent who can answer my questions and provide information about Medicare Supplement, Medicare Advantage, Prescription Drug (Part D), ACA health insurance, long-term care, fixed annuity, life insurance or major medical insurance products and services. The licensed insurance agents who might contact me are not connected with or endorsed by any government agency or program. By completing the contact form above or calling the number listed above, you will be directed to a licensed sales agent who can answer your questions and provide information about Medicare options, such as Medicare Advantage, Prescription Drug (Part D), and Medicare Supplement insurance plans. This is a solicitation for insurance. The communications consented to above include marketing of insurance products. Licensed insurance agents are not connected with or endorsed by the U.S. government or the federal Medicare program. Submitting this form does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage Plan, Prescription Drug Plan, or other Medicare plan. A Medicare Advantage Plan is a health insurance plan provided through a private insurer and delivers Medicare Part A and Part B benefits. A Part D Drug Plan is a prescription drug insurance plan provided through a private insurer and delivers Medicare Part D benefits.