AgencyBloc + Jotform

Create new AgencyBloc individuals from Jotform submissions

Effortlessly manage your client data with this Jotform to AgencyBloc workflow. Whenever a new submission is received in Jotform, an individual will be created in AgencyBloc. Save time on manual data entry and keep your client database updated, so you can focus on providing the best service to your customers.

When this happens...
New Submission
Triggers when a new submission has been added to a specific form.
TriggerInstant
automatically do this!
Create Individual
Creates an Individual in AgencyBloc.
ActionWrite

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Supported triggers and actions

- FormRequired
Trigger
Instant
Try It
- Select a formRequired
- Asignee emailRequired
- Invitation Message
- Assignee Permission
Action
Write
- Select a formRequired
Action
Write
Activity Created
Triggers when an Activity is created in AgencyBloc.
Trigger
Instant
Try It
Group Created
Triggers when a Group is created in AgencyBloc.
Trigger
Instant
Try It

- Mask SSN Data
- Mask Medicare Beneficiary ID Data
Trigger
Instant
Try It
Policy Created
Triggers when a Policy is created in AgencyBloc.
Trigger
Instant
Try It

- Create Activities Description
- Associated With Description
- Associated With - Record TypeRequired
- Associated With - Record IDRequired
- SubjectRequired
- Notes
- Activity Status - Text
- Activity Status - ID
- Activity Type - Text
- Activity Type - ID
- Activity Priority - Text
- Activity Priority - ID
- Activity Method - Text
- Activity Method - ID
- Activity Date
- Due Date
- Due Date - All Day
- Due Date - Start Date & Time
- Due Date - End Date & Time
- Follow-up User - First Name
- Follow-up User - Last Name
- Follow-up User - ID
- Follow-up Team - Name
- Follow-up Team - ID
- Parent Activity ID
- Attach Files From Zapier
- Example Attachment Input
- Attachment Files & URLs
Action
Write
- Create Individuals Description
- First NameRequired
- Last NameRequired
- Middle Name
- Nickname
- Title
- Date of Birth
- Gender
- Social Security Number
- Driver's License Number
- Deceased Date
- Type - Text
- Type - ID
- Status - Text
- Status - ID
- Medicare Beneficiary ID
- Medicare Effective Date Part A
- Medicare Effective Date Part B
- Smoker Status
- Servicing Agent - First Name
- Servicing Agent - Last Name
- Servicing Agent - Middle Name
- Servicing Agent - ID
- Additional Agent 1 - First Name
- Additional Agent 1 - Last Name
- Additional Agent 1 - Middle Name
- Additional Agent 1 - ID
- Additional Agent 2 - First Name
- Additional Agent 2 - Last Name
- Additional Agent 2 - Middle Name
- Additional Agent 2 - ID
- Additional Agent 3 - First Name
- Additional Agent 3 - Last Name
- Additional Agent 3 - Middle Name
- Additional Agent 3 - ID
- Home Phone Number
- Home Phone Number Ext.
- Business Phone Number
- Business Phone Number Ext.
- Cell Phone Number
- Cell Phone Number Ext.
- Fax Number
- Fax Number Ext.
- Address Type
- Is Primary Address
- Address Street 1
- Address Street 2
- City
- County
- State/Province
- Zip Code
- Email Address
- Secondary Email Address
- Opt-Out Of Emails
- Lead Date
- Lead Source - Text
- Lead Source - ID
- Other Lead Source
- Lead Agent/Affiliate - First Name
- Lead Agent/Affiliate - Last Name
- Lead Agent/Affiliate - Middle Name
- Lead Agent/Affiliate - ID
- Project Code - Text
- Project Code - ID
- Individual Custom Fields Note
Action
Write
- Activity IDRequired
Action
Search
- Individual IDRequired
Action
Search
- Email AddressRequired
- First Name
- Middle Name
- Last Name
Action
Search
- Policy IDRequired
Action
Search

- DocumentRequired
Trigger
Polling
Try It
- Select a formRequired
- Assignee emailRequired
- Invitation Message
- Prefilled Field Permissions
Action
Write
- Api Docs Info
- Stop on errorRequired
- HTTP MethodRequired
- URLRequired
- Query string parameters
- Additional request headers
- Body
Action
Write
Activity Updated
Triggers when an Activity is updated in AgencyBloc.
Trigger
Instant
Try It
Group Updated
Triggers when a Group is updated in AgencyBloc.
Trigger
Instant
Try It
- Mask SSN Data
- Mask Medicare Beneficiary ID Data
Trigger
Instant
Try It
Policy Updated
Triggers when a Policy is updated in AgencyBloc.
Trigger
Instant
Try It
- Create Groups Description
- Group NameRequired
- DBA
- Description
- Federal Tax ID
- Industry - SIC ID
- Industry - SIC Description
- Industry - ID
- Employee Count
- Website
- Group Type - Text
- Group Type - ID
- Group Status - Text
- Group Status - ID
- Account Manager - ID
- Servicing Agent - First name
- Servicing Agent - Last Name
- Servicing Agent - Middle Name
- Servicing Agent - ID
- Additional Agent 1 - First Name
- Additional Agent 1 - Last Name
- Additional Agent 1 - Middle Name
- Additional Agent 1 - ID
- Additional Agent 2 - First Name
- Additional Agent 2 - Last Name
- Additional Agent 2 - Middle Name
- Additional Agent 2 - ID
- Additional Agent 3 - First Name
- Additional Agent 3 - Last Name
- Additional Agent 3 - Middle Name
- Additional Agent 3 - ID
- Business Phone Number
- Business Phone Number Ext.
- Fax Number
- Fax Number Ext.
- Address Type
- Is Primary Address
- Address Street 1
- Address Street 2
- City
- County
- State/Province
- Zip Code
- Lead Date
- Lead Source - Text
- Lead Source - ID
- Other Lead Source
- Lead Agent/Affiliate - First Name
- Lead Agent/Affiliate - Last Name
- Lead Agent/Affiliate - Middle Name
- Lead Agent/Affiliate - ID
- Project Code - Text
- Project Code - ID
- Group Custom Fields Note
Action
Write
- Create Policies Description
- Policyholder TypeRequired
- Policyholder - ID
- Carrier - Name
- Carrier - ID
- Policy Number
- Premium
- Lives
- Pay Frequency
- Project Code - Text
- Project Code - ID
- Status - Text
- Status - ID
- Coverage Type - Text
- Coverage Type - ID
- App Submit Date
- Effective Date
- Renewal Date
- Term Date
- Signed By - First Name
- Signed By - Last Name
- Signed By - Middle Name
- Signed By - ID
- Account Manager - First Name
- Account Manager - Last Name
- Account Manager - ID
- Servicing Agent - Agency - Name
- Servicing Agent - Agency - ID
- Servicing Agent - Agent Number
- Servicing Agent - Agent Number - ID
- Servicing Agent - First Name
- Servicing Agent - Last Name
- Servicing Agent - Middle Name
- Servicing Agent - ID
- Additional Agent 1 - First Name
- Additional Agent 1 - Last Name
- Additional Agent 1 - Middle Name
- Additional Agent 1 - ID
- Additional Agent 2 - First Name
- Additional Agent 2 - Last Name
- Additional Agent 2 - Middle Name
- Additional Agent 2 - ID
- Additional Agent 3 - First Name
- Additional Agent 3 - Last Name
- Additional Agent 3 - Middle Name
- Additional Agent 3 - ID
- Additional Agent 4 - First Name
- Additional Agent 4 - Last Name
- Additional Agent 4 - Middle Name
- Additional Agent 4 - ID
- Additional Agent 5 - First Name
- Additional Agent 5 - Last Name
- Additional Agent 5 - Middle Name
- Additional Agent 5 - ID
- Group Policy - Renewal Percent
- Group Policy - New Hire Eligibility - Text
- Group Policy - New Hire Eligibility - ID
- Group Policy - Eligibility Hours - Text
- Group Policy - Eligibility Hours - ID
- Group Policy - Rate Method
- Group Policy - Waiting Period
- Group Policy - Classifications
- Group Policy - Notes
- Individual Policy - Pay Method - Text
- Individual Policy - Pay Method - ID
- Individual Policy - Notes
- Individual Policy - Member ID
- Policy Coverage - Carrier Product - Text
- Policy Coverage - Carrier Product - ID
- Policy Coverage - Effective Date
- Policy Coverage - Premium
- Policy Coverage - Renewal Date
- Policy Coverage - Status
- Policy Coverage - Notes
- Policy Coverage - Fees
- Policy Coverage - Override FieldSet
- Policy Custom Fields Note
Action
Write
- Group IDRequired
Action
Search
- Date Of BirthRequired
- First Name
- MIddle Name
- Last Name
Action
Search
- Phone NumberRequired
- First Name
- Middle Name
- Last Name
Action
Search

About AgencyBloc

AgencyBloc is an agency management system for L&H insurance agencies that includes CRM, commissions processing, sales, and automation tools.

Learn more

Related categories

Sales & CRM

About Jotform

The newly redesigned Jotform lets you build forms faster than ever, with powerful widgets and a responsive editor that works offline—without even needing to sign up for an account.

Learn more