First Name*

    Last Name*


    Your email address*

    Please enter the email address used for your portal login.

    What area do you need help with?*

    We'll ask for more details depending on the topic!

    Which area of Epic do you need help with?*

    Is the agency code listed in your portal as confirmed?*

    Please input the policy number.*

    Which carrier is this policy with?*

    Which agency appointment code is this policy under?*

    If possible, please attach a screenshot.

    Please submit the form below to notify Agency Services of your new code to start ASNOA's download activation process.

    What is the new agency appointment code that needs to be added to your portal?*

    Which carrier is this code with?*

    To submit wholesale business, please use the module inside the portal to submit each piece of wholesale business subject to override. If you are having issues submitting business through this module, or have questions about how wholesale is appearing in your book of business, describe it to us so that we can investigate.*

    Please explain what needs to be updated and/or provide the updated information.

    Is the update for the affiliate agent, agency, or your staff?*

    Which category does the update fall under?*

    For all details related to staff, please see our Staff Intake Form here. You can add new staff, change splits, request epic training and more. If you urgently need to terminate access for staff or have permissions changed, please call our Education team.

    Please double-check. Is ASNOA listed as coinsured?*

    Please review the license and add ASNOA as co-insured. If you have any questions, please reach out to our Agency Services department.

    What license are you submitting?*

    What is the license number?*

    What is the expiration date?

    Please upload a copy of your license

    Which issues are you experiencing with EZLynx?

    For which platform do you need login or credential access help?*

    What kind of assistance do you you need?*

    Which reports do you need help with?*

    What issues are you experiencing with the producer commission report?*

    For instructions on how to submit outstanding commissions policies, please download the Outstanding Commissions Guidelines in the portal. If you have questions about an outstanding policy not showing up, or one that you have submitted still appearing on the report, describe the issue below so that we can take a look.

    Please describe what/whose access you would like to change.

    If you haven't already, try to follow the prompts on the login screen for the Education LMS to reset the password yourself.

    Use Epic Browser and follow the steps to reset the password from the login screen. The reset password will be sent to the user's email address. If this is outside of ASNOA's business hours, you can also call Applied Epic for password resets at 1-800-999-6512.

    Please let us know the carrier in question.*

    If that does not work, enter the name of the person who needs a password reset and press submit to send a password change request to our team.

    In addition, feel free to schedule a session one of our trainers through this link here.

    Please share additional detail about your question or what you need assistance with so our team can investigate or update your information:

    Questions with an asterisk, "*", are required.