A referral that is worth it

Calculation example: In the event of the successful referral of a family of four, you would receive CHF 50/person.

Upon conclusion of a supplementary insurance.

Refer us to your friends and simply sharing joy

My address

0% Complete
Your referral

0% Complete
Further referrals

0% Complete

Metadata

User Id

Form Uuid

Language

Webmail2Id

mailTo

Bcc

formType

resourceDownloadUrl

onServer

Title

Mrs./Ms.

Mr.

Surname

First name

Street, n°

Postcode

Town

Insurance number

Your message

Date of birth

Please contact me by

phone

e-mail

mail

Bitte vergessen Sie Ihre Kontaktangaben nicht, damit wir Ihre Anfrage bearbeiten können.

Phone

E-mail

I confirm that I have received permission from the recommended person to share their contact details for this purpose.

Title

Mr.

Mrs./Ms.

Family

Surname

First name

Street, n°

Postcode

Town

Date of birth

Phone

E-mail

Number of persons in the household

Please specify the other members of the household.

Your CONCORDIA agency

Further referrals?

Yes

If you refer a family, it is sufficient to specify one name.

I agree to inform the person accordingly.

Title

Mr.

Mrs./Ms.

Family

Surname

First name

Street, n°

Postcode

Town

Date of birth

Phone

E-mail

Number of persons in the household

Please specify the other members of the household.

Your CONCORDIA agency

Clients recruit clients

Refer us to your friends and simply sharing joy

Metadata