This insurance is medically underwritten, meaning your health history can impact both the approval and cost of your application and policy. This information helps us more accurately assess your eligibility and more accurately provide a quote.
This health questionnaire usually takes 7-15 minutes, saving time and preventing future surprises (have your prescription information handy).

Important notes:

- This is not an application; it is a pre-application step.
- Representatives at David White and Associates and their support team at LTCI Partners, LLC, reviews this information for the sole purpose of gauging your eligibility and rate classification.

If you stop and want to return to finish this questionnaire, your information is NOT saved, and you will need to start again.

This Questionnaire is HIPAA compliant.
Questions?
David Lucas
(925) 277-2629
dlucas@dwassociates.com
 
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