You are communicating with Rip Curtis.
How would you prefer to do this? *
Are you the person to be insured? *
What is your relationship with the person to be insured? *
An established client? *
Communication will be routed through you for now.  
From here on out, the term "you" refers to your client because most of these questions relate to risk assessment of the person to be insured.
Where are you in the process? *
The information you provide on this form will be used to prepare the application kit.  There will be another chance to finalize or change your answers after you finish this form.
Your client's client's contact information is not required as this stage.
Where in the process is the group? * 🛈
Please use the legal name of the group, as this will be on the policy.