Gathering as much medical information on a client before taking an application with a carrier is the most important part to the entire application process. Click on a condition listed below for a specific questionnaire to enter specific medical information on a client. To request a quote, please complete the appropriate form at the bottom of the page.
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Life Quotes
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DI Quotes
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LTC Quotes
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Short-term Quotes
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Medical Records
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For Life quotes, complete the quote request form and we will pre-screen your prospect, and recommend to you which carrier(s) will offer the best solution for your client, based on the plan, premium goal and the client's health, occupation and avocations.
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For DI quotes, complete a Disability Quote Request and we will pre-screen your prospect, and recommend to you which carrier(s) will offer the best solution for your client, based on the plan, premium goal and the client's health, occupation and avocations.
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For LTC quotes, complete a LTC Request form and we will work with you to determine the best solution for your client, based on the plan, premium goal and the client's health, occupation and avocations.
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For Short-term Care quotes, complete a Quote Request and we will work with you to determine the best solution for your client, based on the plan, premium goal and the client's health, occupation and avocations.
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Medical Records: We recommend that clients either obtain their medical records, before completing an application, or allow us to order their records. Download the Authorization Form to be signed by the client, which allows our office to obtain medical records for review.
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