INFORMAL APPLICATION

Click Here to access our Informal Application.  This can be used to fill out general medical and financial underwriting information on your clients.  We'll take this information to our on-staff underwriters to help determine which carriers will give us the best rating possible.

Underwriting Questionnaires

Click Here to see a full list of Underwriting Questionnaires to use with clients on specific underwriting conditions.  We'll take this information to our on-staff underwriters to help determine which carriers will give us the best rating possible.

Multi Hipaa Form

Click Here to access our Multi HIPAA Form.  This form will allow us to receive client medical records and lab results. From here we'll send this medical information to all of the carriers we work with, so we will be sure we are receiving the best rating possible for your client on an informal basis.