Becoming an Agent or Introducer.

If your business is FCA registered, you can apply to be a Health Shield Agent. If not, you could still do business with us as an Introducer.

If accepted, we’ll send an agreement with the terms and conditions and set you up with an Agency or Introducer code. One of the team will get in touch and welcome you to Health Shield.

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Apply to become an Agent or Introducer.

To find out what we do with the information you provide, please see our Privacy Policy

All the fields marked with an asterisk (*) are mandatory.

Please enter the FCA Business reference number

Please enter your full name

Please enter your street address

Please enter the name of your city

Please enter the name of your state / province / region

Please enter your postcode

Please select your country

Please enter your telephone number

Please enter a valid email address

Please enter your previous and/or current business/profession/occupation

Please enter your professional qualifications

Yes

No

If Yes, please give details

Yes

No

If Yes, please give details

Yes

No

If Yes, please give details

Yes

No

If Yes, please state the names of the companies

Yes

No

If Yes, please give details

I declare that the information provided in this application is true and complete.

Please check the above checkbox to continue

Please complete the reCAPTCHA

Let’s get the ball rolling.

We're here to help so drop us a line, we'd love to hear from you.