Health Quote Insider

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Is any insured a frequent tobacco user?

Do you currently have health insurance in force?

Are you self-employed?

Does your family have a history of cancer, stroke or heart disease?

Check any of the following you or any insured has been diagnosed with in the past 10 years:
	AIDS/HIV	Alzheimer's Disease	Cancer
	Heart Disease	Kidney Disease	Liver Disease
	Mental Illness	Pulmonary Disease	Stroke

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