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Discovery Call
Thank you for filling out this form. The information below will be used to identify your areas of interest such as health/life insurance and legal services.
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Email
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Record my email address with my response
Customer First/Last Name
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Your answer
Name of Organization/Business
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Your answer
Best Contact Number
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Your answer
How Did You Hear About The Discovery Call?
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Networking In Person With Larry Blackmon
LinkedIn Post
Virtual Networking: LinkedIn Messaging
Facebook
Saw On Interview/Podcast
Other:
Which best describes your healthcare coverage status?
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I currently have healthcare coverage, but I am open to learn about additional options
I have not had healthcare in over 3 months
I have not had healthcare in over 12 months
I have not had healthcare in over 2 years
I have never had healthcare coverage
Other:
Which best describes your employment status?
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Employed Full Time
Employed Part-Time
Unemployed: In Transition To Locate New Employment
Self Employed: Full Time with less than 3 employees
Self Employed: Full Time with less than 15 employees
Self Employed: Full Time with more than 25 employees
Self Employed: No staff/employees
Other:
What topics would be of interest during our discovery call session?
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Health Stability: I am in good health, but I would like to have something in place to protect myself
Life Transition: I have just switched to an industry that puts me a higher risk of injury
I am self employed and I have not been able to locate affordable health insurance
Health Stability: I didn't think I needed health insurance until now since I am starting a family
Health Stability: I had health insurance, but I lost it after no longer working for my employer
Health Education: I may be interested in Health Insurance if I had a deeper understanding of the benefits for me personally
Health Patterns: A hereditary disorder runs in my family that may impact my eligibility, so I want to be proactive
Health Proactivity: I witnessed a friend/family disadvantaged because they didn't have health insurance
Custom Health Care: I take good care of myself, therefore I want to find a smaller, customized plan
Health Improvement: I use to neglect my health, but I am motivated to be much more proactive
Dental Care: I'd love to learn about a customized dental plan that could help me
Health Inquiry: Can I obtain affordable health insurance if I occasionally use tobacco products?
Preexisting Conditions: What timeframe qualifies as preexisting condition?
Health Coverage: I currently have health insurance, but I am not sure of what it entails
Health Coverage: My health coverage doesn't cover me outside of my home state
Health Coverage: My doctor is no longer serving in my network
Life Insurance: I am not 100% sure how much coverage I should have in place to protect my family
Price Threshold: I have been interested in health insurance, but the premiums were way too expensive
Health Coverage: My health insurance has/had extremely high deductibles
Qualifiers: I feel the premiums should be based upon my health, not based upon income level
Agent Communication: I do not know who my health insurance agent is or haven't spoken to them
Health Coverage: I felt like I purchased a policy that wasn't customized for my family's needs
Industry Expertise: I'd prefer to have someone guide and educate me about the value of health coverage
Coverage Mobility: It would be nice if my coverage could remain with me if even my job status changed
Health Coverage: Policy that travel outside the state/country
Time Frame: I Need The Policy To Start ASAP
Time Frame: I Need The Policy To Start In 15 Days
Time Frame: I Need The Policy To Start In 30 Days
Time Frame: I Need The Policy To Start In 45 Days
Other:
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