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Fischer Financial Group is committed to providing you with a fast, efficient means of gaining more information about our products and services. For all product inquiries, please complete the requested Contact Information below. If you would like to receive product information, please fill out the Preliminary Information On Persons To Be Covered section; then scroll down to click Submit. If you have a general question, scroll below to the General Product Questions section; then click the Submit button.

For faster service, simply dial 1-570-323-3600. We'll be glad to assist you.

Contact Information

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*First Name:
*Home Phone #:
*Last Name: Cell Phone #:
Address 1: Work Phone #:
Address 2:
Fax #:
City: E-mail Address:
State:
When is the best time to contact you?
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Preliminary Information On Persons To Be Covered

Primary Insured Spouse Information (if applicable)
First Name:
First Name:
Age:
Age:
Gender:
Gender:
Height:
Height:
Weight:
Weight:
Any tobacco use in the last 12 months?Yes No Any tobacco use in the last 12 months?Yes No
Number of children to be covered:
Children's ages: , , , , , ,

General Product Questions

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Fischer Insurance Agency
1735 East 3rd Street
Williamsport, PA 17701

1-570-323-3600
Fax: 570-323-1799

Copyright 2010 - Fischer Insurance Group