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Health Assessment Questionnaire


Uncover Pricing Information Before You Apply!

Please click here to view our online health assessment questionnaire, complete the simple formRisk Assessment Form and we will do the rest. This will enable us to generate an accurate rate quote before you apply for life insurance. This form is confidential, secure, and encrypted, and it’s a snap!

*Complete the simple form (it takes about 5 minutes). No emailing or faxing back. Just click the submit button, and that’s it. We will review the information and contact you with an accurate rate classification and life insurance quote.



Prior to Applying, Get a Health Evaluation

A simple health assessment before applying is essential in securing the best ratesprescreening medical conditions you may qualify for. Find out which carriers are best for you and eliminate unwanted surprises. Having any health conditions could affect the final rates of your application. However, we want to limit their impact on your premium.

Investing a few minutes of your time with a simple risk assessment can help you secure the best life insurance rates possible. Also, keep in mind that this is not just limited to health-related issues. For example, even smoking marijuana can affect your rates.


What Type of Medical Conditions Can Impact Your Rates?

Medical conditions are otherwise known as health conditions. These could include conditions such asmedical pre-sceens high cholesterol, hypertension (high blood pressure), diabetes, heart conditions, being overweight, COPD, aneurysms, and Alzheimer’s disease. Also, conditions such as Anxiety, Depression, Alcoholism, Dementia, HIV, Epilepsy, Hyperglycemia, Kidney Disease, Strokes, Asthma, and many others.

A medical condition assessment can save time and help find the best life insurance rates. Choosing the right life insurance company to use is the most critical decision. Using an insurer that is liberal to your health concerns is paramount.


Hazardous Occupations!

Hazardous occupations such as Structural Iron and Steel Workers, Farmers and RanchersInstant Online Quotes including Agricultural Managers, Truck Drivers, Drivers, and Sales Workers, Construction Workers & Laborers, Refuse and Garbage Collectors, Electrical Power Line Repairman & Power Line Installers, Roofers, especially the Commercial Roofer working with hot tar, Airplane Pilots and Helicopter Pilots along with Flight Engineers,

Logging workers, otherwise known as Loggers & Lumberjacks, Commercial Fishermen working in the oceans, and several others.


Dangerous Sports & Hobbies

Some of these sports would be Scuba Diving, Skydiving, Bungee Cord Jumping, White Water Rafting, Base Jumping, Bull Riding (Rodeo), Motorcycle Racing, Rock Climbing, Drag Racing, Boat Racing, Stock Car Racing, Private Airplane and Helicopter flying just to name a few. Unfortunately, most people never realize that their favorite sport or hobby could cause an issue when they go to apply for life insurance.

Some companies will allow a dangerous sport to be excluded from a policy. Some of the carriers will even enable you to ask for reconsideration if you quit your involvement in the sport, which would reduce your premiums.

All the best,
Jack Venturi


Jack Venturi Independent Life Insurance Agent

Jack Venturi

Independent agent and founder of

Jack Venturi has over 30 years of experience selling all forms of individual and commercial insurance, including Property & Casualty, Health, Disability, and Life insurance. Jack has helped thousands of people all across the United States purchase the best insurance products at the lowest premiums possible over the phone (815) – 390-7545.

We’re Here For You 7 Days A Week

We empower individuals with product knowledge about life insurance.
This will guide you to discover the ideal policy at the most affordable rates.

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