TAX FORM REQUEST: 1095 B TAX FORM REQUEST: 1095 B Complete the form and all required fields, along with your email address or phone number so Client Services can reach out to you if they have questions. Alliant Client Services can be reached at 866-403-2785. "*" indicates required fields Name* First Last Email* Phone*Preferred Contact*By EmailBy PhoneAre you a Member?*Yes, I’m a MemberNo, I’m not a MemberSelect your preferred call back time below: Hours : Minutes AM PM AM/PM Your Member ID: Show Member IDDate of Birth Show DOBStreet Address Show AddressPlease provide a short summary below:NameThis field is for validation purposes and should be left unchanged.