Impaired Risk Term Life Insurance Quotes rates

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Impaired Risk: Asthma - Hepatitis - Stroke - Substance Abuse - Addictions - Excssive Prescriptions - Liver Enymes - Diverticulitis

Our online quotes will accurately put you in the “ball park” but ultimately you will choose from insurance plans that are customized to your personal lifestyle and medical history. Be specific about what your impaired risk is:

High Blood Pressure * Asthma * Hepatitis * Stroke * Substance Abuse * Addictions * Excessive Prescriptions * Elevated Liver Enzymes * Diverticulitis: GET THE IMPAIRED RISK SPECIALIST, ShopTermQuotes.Com to guide you through the maze and GET APPROVED! NOT DECLINED!!!! We know how to frame your condition so that it is best understood by underwriters so that they may make an informed assessement of your personal medical history. Call us now at 1-800-264-8114 or email the head of our Impaired Risk Insurance Department,Email: Tim Mouton: tmouton@shoptermquotes.com

One of our experienced, professional, licensed agents will contact you within 24 hours to discuss your options and help you choose an affordable plan that is right for you. If you are ready now, call us toll free at 1-800-264-8114.

When purchasing insurance through Shop Term Quotes Insurance Services,
you are investing in your peace of mind.

GET THE ANSWER YOU NEED - NOW!

We are your Impaired Risk Specialist!

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Underwriting Questionnaire For Most Impaired Risk

Personal Information

First Name:

Last Name :

State :

Daytime Phone:

Date of Birth :

mm dd yy

Evening Phone:

Gender :

Male Female

Cell Phone:

Height:

Best Time to Call:

Weight (lb):

Email:

Coverage Information

Tobacco:

Yes No

Type of Tobacco:

How much?

Amount of Insurance:

Type of Insurance:

Have you previously been declined for insurance? Yes No

Which Company?

Health Information

Do you have high blood pressure? Yes No

Systolic Rating:

Diastolic Rating:

Do you have high cholesterol? Yes No

Cholesterol:

HDL Ratio:

Family history (Parents, Siblings) of cancer or heart disease? Yes No

Parent

Age of Diagnosis:

Age of Death:

Siblings

Age of Diagnosis:

Age of Death:

Health Conditions

Cancer	Alcoholism	Alzheimer's
Depression	Heart Disease	Sleep Apnea
Diabetes	Hepatitis	Liver Disease
Rheumatoid Arthritis	Stroke	Parkinson's
Kidney Disease	Leukemia
Other Details: Please be as specific as possible or call us now 1-800-264-8114 WE HAVE SUCCESSFULLY OBTAINED COVERAGE FOR THOSE PREVIOUSLY DECLINED!

Hazardous Activities

Activities	Details:
Aviation
Scuba Diving
Other
Moving Violations, DUI:	Yes No	Details:

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