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  • The undersigned Toll Free number holder does hereby appoint Grand Canyon Business Solutions as the Responsible Organization for toll free numbers.

  • Please do not include Standard 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.
  • Please enter your company name.
  • This is the day you would like the Toll Free 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 Toll Free 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.
  • This is the primary fax number located on your last phone bill if applicable.
  • 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.
    Drop files here or
    Accepted file types: jpg, gif, png, pdf, Max. file size: 2 GB.
    • Do not cancel service with your current phone service provider until you receive notice that your toll free number has been successfully ported and is active on GCBS.

    • This is the new RespOrg your toll free numbers will be ported into:
      New RespOrg: AUC72
      New RespOrg Contact: Eastern Rep
      New RespOrg Telephone Number: (541) 593-2900
      New RespOrg Fax Number: (541) 593-2090

    • Please enter any additional questions or comments here.