To request that PISI, AMBA, PISI/AMBA, Mowery Associates and/or the Professional Insurance Association and their affiliates stop all communications regarding your vision and dental benefits, please fill out the short form below.
To whom it may concern:
Please be advised that I am rescinding all correspondence regarding discontinuation of my PASR dental insurance and I am continuing my deductions with PASR for payment. I wish to exclude PISI and their affiliates from making ACH withdrawals and issuing dental and/or vision policies to me effective immediately.
Also effective immediately, I further request to stop receiving all and any future communications and solicitations by letter, email, phone, or any other form of communication from PISI, AMBA, PISI/AMBA, Mowery Associates and/or the Professional Insurance Association and their affiliates.