Please do not include Toll-Free DIDs that need to be ported on this form - they each have a separate porting form.
* = Required
Please enter the account owner's first and last name here.
Please enter the account owner's email address here.
This is the day you would like your phone number(s) fully ported over to AZ Health Systems. This port date is not guaranteed and we will send a confirmation on the port date once received. Please leave this field blank if you would like GCBS to schedule this porting date.
MM slash DD slash YYYY
Please enter all of the phone numbers that you would like ported over to AZ Health Systems. The + icon to the right of the blank space will create an extra phone number entry line.
Additional Porting Information
Please enter the account owner's title here.
This is the primary phone number located on your last phone bill.
Please enter the account number for the previous telecom service provider. (This information can usually be found on the most recent phone bill/invoice.)
This information is only used if it's required by your current/old telephone service provider for phone number porting.
The most recent phone bill is required for successful porting.
Accepted file types: jpg, gif, png, pdf, Max. file size: 2 GB.
Drop files here or
Do not cancel service with your current phone service provider until you receive notice that your number has been successfully ported and is active on GCBS. To do so will cause you to lose your phone number(s). Cancellation of a LNP request incur cancellation fees.
Please enter any additional questions or comments here.