For VGF Reps Returning Call to Prospect (1st attempt)

Please provide prospective client's info here. If the prospect submitted the Take Action form via the site, please only include Name and then skip down to "DISPOSITION" (no need to duplicate info).

Inbound contact method
Name
Name
Phone
Phone
May we leave a detailed voicemail?
If you are planning to use Out Of Network benefits, what is your insurance company?
DISPOSITION
IF SCHEDULED--Provider
IF SCHEDULED--Payer
IF NOT SCHEDULED--Reason for loss