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๐ Quick Start Quote
Hi there! Just need to confirm a few quick things so I can prepare your custom options.
Takes less than 60 seconds.
โ
What is your
full name?
*
๐ก
What's your
address?
*
๐
What's your
age?
*
๐
What's your
height &?
*
๐ท What's your
weight?
*
๐ฐ
What's your
mortgage amount?
*
๐
What's your
monthly payment?
*
๐ฅ
Is there a
co-borrower or spouse
on the home
?
*
๐ฅ Is there a co-borrower or spouse on the home?
A
Yes
B
No
C
Other
If yes, what is your co-borrowers full name?
*
Hazardous Occupation?
*
If yes, Occupation
*
๐ฌ Nicotine Use?
*
๐ฌ Nicotine Use?
A
Yes
B
No
โค๏ธ
Any
major
health concerns
(like diabetes, heart issues, cancer, etc.)
?
*
Perscriptions? Type and name.
*
What is the main reason that you want this protection?
(ex. I don't want my family to have to worry about losing our home.)
*
๐ฉ
Whatโs a good
email
so I can send you a Zoom link & business card
?
*
Want more info?
Thanks for your time today! I will get to work on this for you and text you when I am done. Then we can set up a review at a time that works best for you. Please tap Submit and you will be directed back to our home page.
Submit
