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Please follow these three steps to enroll and get started. Thank you for your interest in Wells Fargo Retail Services and we look forward to helping you achieve your business goals!


Complete and print the appropriate enrollment form for your business from the list below

Dental work enrollment form (PDF)
Hearing health enrollment form (PDF)
Veterinary care enrollment form (PDF)
Vision enrollment form (PDF)


Review all forms to ensure completion.*


Fax all completed forms to 1-877-279-4548

Questions regarding the enrollment form?

Please call 1-800-577-5221 Monday- Friday, from 7:30 a.m. to 5:30 p.m. Central Time.

* Please refer to the checklist, included with your enrollment documents, to assist with proper, accurate completion. Faxes with missing pages and/or incomplete information will delay the enrollment process.

Note: All forms are designed so you can open and complete the documents by typing the requested information into the document. This will help reduce the need for you to enter duplicate information and assure legibility.