Individual and
Family Health Insurance Policies are Medically Underwritten
A preliminary evaluation form is used to determine if a health insurance carrier would be likely to approve
your application. It is based only on the information you provide on this form. It is only an informal opinion of how the
insurance carrier might react to a submitted application containing identical information, and is intended to assist in deciding
what health insurance coverage might be appropriate.
Click on the link below, complete the information requested and fax
to Keating Insurance Services, LLC at (520) 797-0332 or email to tom@keatinginsurance.net