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Your safety deserves clarity, not guesswork.
Let us tailor a plan that truly works for you.
Which State in America do you live in?
Your gender as listed on your government-issued ID
Select one
Male
Female
Date of Birth
Select month
January
February
March
April
May
June
July
August
September
October
November
December
How is your health?
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Excellent
Great
Average
Do you use cigarettes, vape, or any nicotine alternatives regularly?
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Yes
No
How many kids do you have?
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0
1
2
3
4+
Do you have a monthly budget in mind for your coverage?
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$20 - $50
$50 - $100
$100 - $200
$200+
I'm not sure
Is there a target amount of coverage you're aiming for?
Select one
$50k - $100k
$100k - $300k
$300k - $500k
$500k - $1M
Over $1M
I'm not sure
Are you a citizen or permanent resident of the USA?
Select one
U.S. Citizen
Permanent Citizen (Green Card)
None of the above
How do you wish to receive your quote?
via Email
via Text
via Phone Call
How did you hear about us?
Social Media (FB/IG)
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Referrals (Learn more about our
Referral Program
)
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