Please enter all the information requested below and then click the "Submit" button located at the bottom of this page. Remember to have electronic copies of your tax return and paystubs available for upload. Following receipt of your information, GotZoom will develop, at no cost to you, a benefit summary which includes program options, recommendations and your estimated savings.
If you have questions regarding the many program options and eligibilities, or if you would like assistance populating the information below, please don't hesitate to contact the GotZoom Help Desk at 1-833-468-9666.
Completing this GotZoom Client Intake Form does NOT constitute a commitment or obligation.