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Personal Insurance Discovery
If handling live- Schedule Live Discovery Call first
Resource Guide
Discovery Intro Script
Client Data Sheet
Intake Form
First Name (as it appears on your Driver's License)
(Required)
Last Name (as it appears on your Driver's License)
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
Email
(Required)
Which type of insurances you would like to review?
(Required)
Auto Insurance
Homeowners Insurance
Umbrella Insurance
Other
Select All
Do you have access to send us your Dec Pages?
(Required)
If Yes, "Great! After our call, you’ll get an email with a secure link to send your documents and schedule an appointment with an advisor.
If they want to send them to us while on the phone, you can text them this link: https://www.hta-insurance.com/individuals/hta-document-upload-personal/
If No- "Unfortunately in order to provide a comprehensive review we do ask you to provide us with a copy of your dec pages, That way, we can match your coverages up properly and spot any gaps you might not be aware of"
When was the last time you had a full insurance review?
(Required)
What are your main concerns or areas where you feel you may need more coverage?
(Required)
Auto Insurance Questions
Please include information on all drivers in your household
How long have you been with your current company (approx years)?
(Required)
0
1
2
3
4
5
6+
How many vehicles are in your household?
(Required)
0
1
2
3
4
5
6
How many drivers are in your household? (INCLUDING you)
(Required)
0
1
2
3
4
5
6
Driver 1 Information (YOU)
Drivers License #
(Required)
Driver 2 Information
Full Name
(Required)
Relationship to you
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
Drivers License #
(Required)
Driver 3 Information
Full Name
(Required)
Relationship to you
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
Drivers License #
(Required)
Driver 4 Information
Full Name
(Required)
Relationship to you
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
Drivers License #
(Required)
Driver 5 Information
Full Name
(Required)
Relationship to you
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
Drivers License #
(Required)
Driver 6 Information
Full Name
(Required)
Relationship to you
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
Drivers License #
(Required)
Homeowners Insurance Questions
Tell us about your property:
How long have you been with your current company (approx years)?
(Required)
0
1
2
3
4
5
6+
Do you have any of the following?
(Required)
Includes a swimming pool
Includes a trampoline
There are farm animals or exotic pets living on this property
There are dog(s) living on this property
Business is conducted from the property
Household employees (Housekeepers, Nanny, etc.) live on the property
none of the above
(check all that apply)
Approx Year Roof last updated or replaced?
(Required)
Have there been any updates to the Heating, Plumbing and/or Electrical? If so, in what year?
(Required)
Umbrella Insurance Questions
Select any items below that you may own:
Automobiles
Owned properties (Primary, Secondary or Rental)
ATVs, Boats, Jet Skis and/or Motorcycles
Other Insurances
Provide information on the other insurance coverage you would like to discuss:
Additional Information
Provide any additional details or questions you may have so we can best prepare for your appointment:
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