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Do you take any prescription medications?

Have you ever had any health conditions such as diabetes, cardiovascular disease, cancer, depression, or surgeries?

Did any of your parents or siblings have cardiovascular disease or cancer, prior to age 60?

Do you engage in any hazardous activities such as private piloting or scuba diving?

In the past 10 years, have you had any DUIs, or have you had more than 2 moving violations in the past 3 years?

Have you ever been convicted of a felony?

In the past 5 years, have you filed for bankruptcy?

Do you currently have any life insurance in force?

Do you currently have any life insurance applications in process?

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