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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

Click here for Employee & Family Medical Questionnaire.pdf


Specializing in Health, Life, Disability and Long Term Care Insurance for Individuals, Families and Small Businesses!