Download Dental Forms

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Fidelity Security Life Insurance Company

 > Dental Design Sales Brochure
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Allied Dental Design Sales Brochure

> Employer Administrative Guide

Guide for employers to administer group benefits

> Employee Enrollment/Waiver

> Dental Design Employer Application

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> Self Service Site Administrator Authorization Form

Form employees use to enroll or waive coverage.

Multi-state dental employer application. Call Allied's Sales Support 888-767-7133 for state-specific applications for: CA, CO, FL, GA, ID, KY, NM, TN and WA.

This form is required and allows one or more representatives of the employer to access the Self Service website.

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Miscellaneous Underwriting Forms

> Affidavit - Committed Domestic Relationship

"Committed Domestic Relationship" affidavit for use with Allied group medical and dental plans.

> Affidavit - Participating Business Owner

A Participating Business Owner must use this Affidavit to certify eligibility to participate in
an Allied Group Plan on the same basis as an eligible employee.

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Formas en Español (Spanish Forms)

> Allied No Médico Formulario de Inscripción del Empleado

Employee Enrollment Form.

If you are unable to find what you're looking for, please contact Allied Client Services.

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Looking for something different?
Download brochures, applications, and other resources for all Allied plans. Use these materials to present plan options to your clients.