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Get An Insurance Quote with LaToya Batiste
Insurance is an important financial tool. It can help you live life with fewer worries knowing you'll receive financial assistance after a disaster or accident, helping you recover faster.
With exclusive tools and a committed team, LaToya Batiste is ready to assist you with all of your insurance needs. Together, let's build your family's legacy.
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First name, middle initial & Last name:
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Your answer
DOB:
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Your answer
Age:
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Your answer
Gender
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Female
Male
Phone Number:
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Your answer
Email Address
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Your answer
State of Residence:
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Your answer
Nicotine or Tobacco?
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Yes
No
Height:
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Your answer
Weight:
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Your answer
ATTENTION!!!! PLEASE BE HONEST REGARDING ALL MEDICAL QUESTIONS, HOSPITALIZATIONS, MEDICATIONS ETC. I WORK FOR YOU, NOT THE INSURANCE COMPANIES. BUT IN ORDER TO PROPERLY HELP YOU I NEED HONESTY SO I CAN CONNECT YOU WITH THE BEST COMPANY.
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List of prescribed Medications & what it's treating even if you're not taking them:
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EVER HAD ANY of these Health Concerns? If yes, please include date under the "other" section.
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Heart Conditions
Brain Conditions
Kidney Conditions
Liver Conditions
Stroke
COPD/Emphysema
Cancer
Other
NO HEALTH CONCERNS
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Covid within the last 6 months?
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Yes
No
If yes to covid, what date?
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Any complications from covid?
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Yes
No
New Diagnosis, Surgeries or Hospitalizations in last 5 years? If so, please explain below.
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Felony or Misdemeanor within 10 years?
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Felony
Misdemeanor
None
Both
If yes to the above question, please provide the date.
Approximate date will suffice if you don't have the exact date.
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Do you know the type of insurance you’re shopping for? If so, what type?
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Example: Whole life, term, final expense etc
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How much coverage you’re looking for?
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Example: 50K, 100K, 500K etc.
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About how much are you expecting to pay towards the coverage of insurance mentioned above?
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Want a quote for a spouse or kids? Please SUBMIT another form for SPOUSE and ADULT KIDS 18 and older. For Kids 17 and under, provide age, health concerns and height and weight below:
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PLEASE TEXT ME CONFIRMING THE FORM WAS SUBMITTED!
337-255-5842
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