Ambetter Van Request Form

Bring the Ambetter Health experience to your event with our branded van. Our field representative will be on-site to hand out Ambetter Health promotional items and discuss the benefits of our plans. Fill out the form below to schedule the Ambetter Van and enhance your event with valuable health information and giveaways. Event must be in Florida.

Event name *

Event location *

Event date *

Event start time *

Event end time *

Description of event *

Organization name *

Contact name *

Organization email address *

Organization phone number *