Life Insurance Questionnaire
Please complete the form below and I will personally reach out to you. The answers to the following questions will provide me with a better idea of your financial picture, your needs, potential gaps, and how I can service you.

Please note: I am a licensed insurance producer working as a broker which means I may represent multiple companies to meet your needs.

*All submissions are completely confidential and only viewed by myself (Lovisa Woodson). I will never sell your information or bombard you with annoying calls/texts/emails after your submission. It's my promise!
Email *
How do you identify? (For rate determination only) *
Full Name *
When is your birthday? *Has a direct impact on your rating. *
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What state do you live in? *Applications and availability vary by state. *
Mobile Number *If you are not comfortable being contacted by phone please withdraw your inquiry now. *
Marital Status *
How many dependent children do you have? *
Do you have a will? *
Do you have an established budget? *
Do you have an emergency fund of at least 6-9 months living expenses? *
Do you own a home with a mortgage? *
How is your health? *
Do you use nicotine products? (tobacco, cigarettes, vapes, etc.) *
Do you have an existing life insurance policy? *
When are you looking to purchase life insurance? *
Who do you need life insurance for? *
Required
If you've recently used a life insurance needs calculator, what's the minimum amount of life insurance recommended for you? If you'd like, you can access the calculator here https://lifehappens.org/life-insurance-needs-calculator/ and we will also do a further analysis when we speak.
What's your most important financial goal in the next 1-3 yrs? *
Check all that are important to you: *
Required
Taxable Assets: Assets generally positioned for current or short-term needs that can be best served with liquid instruments. *
Required
Tax Deferred: Assets are earmarked for long term needs, such as college funding and retirement. These assets are invested in less liquid investments where any growth or interest is ultimately taxable at distribution. *
Required
Tax Advantaged: Assets are positioned for the future since they receive preferential tax treatment during accumulation and at distribution. *
Required
Do you currently work with a financial professional to help you reach your goals? *
Are you a business owner in need of benefits such as a retirement savings/investment account, disability insurance, or benefits for employees? *
Anything else you'd like me to know before our appointment? *
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