You must fill out all required fields before you can submit your application. Please correct the errors below (highlighted in red).
Please complete all fields below. After clicking submit you will have a chance to review and edit your information. Once all of your information is correct, you may print out the application and fax or mail it in along with a legible copy of your driver’s license or valid ID along with your initial account funding. If you're authorizing another party as an Account Signer, please include a copy of their driver’s license as well.
Faxed applications should be sent to: 866.826.0104 (Attn: HSA Department). Mailed applications should be sent to: Falcon National Bank, Attn: HSA Dept., 1010 West St. Germain St., Suite 150, St. Cloud, MN 56301.