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GPEZ Concierge Service

If you’re tight on time, let us do the rest.
For a one-time $50 fee, we will complete your client’s application on your behalf.

Click on the following links for information and forms:

GPEZ Overview
GPEZ Request Form
GPEZ HIPAA & NPI Authorization Form
GPEZ Client Preparation Flier
GPEZ Agent Signature Page

Promptly email, fax, mail, or deliver ALL forms listed above to GPAgency:
Fax: (877) 821-7191
Mail/Delivery: 7000 Six Forks Rd., Ste. 103, Raleigh, NC 27615
(Hours M-Th: 8:00 am – 5:30 pm / Fri: 8:00 am – 3:00 pm)