Sample Leads
Health
| Have you used any form of tobacco in the last 12 months? | Yes | ||
| Are you currently insured or have been insured for the past 30 days? | Yes | ||
| Is anyone in the family self-employed? | No | ||
| Has anyone in the family been treated for any of the following? Cancer, High Blood Pressure, Diabetes, Asthma, Immune System Disorders, Depression/Anxiety, Heart Disease, Drug/Alcohol Abuse, Epilepsy, or similar |
No | ||
| Health Plans: | Individual & Family Health Plans | ||
| First Name: | John Doe | Last Name: | Monkey |
| Date of Birth: | 1975-01-01 | Gender: | Male |
| Height: | 5' 6 | Weight: | 150 lbs. |
| Street Address: | Main St. | Zip Code: | 38017 |
| City: | Collierville | State: | TN |
| Day Phone: | 123-123-1234 | Cell Phone: | 123-123-1234 |
| Email: | johndoemonkey@quotesmonkey.com | ||
| Has anyone in the familty been treated by a physician in the last 12 months? | Yes | ||
| Has anyone in the family been hospitalized in the last 5 years? | Yes | ||
| Is anyone in the family currently taking any prescription medications? | Yes | ||
| If you have answered 'YES' to any of the above questions, please describe: | [hidden] | ||
| Is anyone in the family an expectant mother? | No | ||
| Has anyone in the family had DUI/DWI in the last 5 years? | No | ||
| Have you been a resident of the U.S. or Canada for the last 12 months? | No | ||
| What is your occupation? | Internet/News Media | ||
Promotions
Ask about our new customer reward the 50/50 plan... If you are a new customer and you deposit 250 or greater towards your intial deposit, we will match your deposit up to 1000.00 dollars
For example, if you make a 500 deposit we will add a 500.00 credit balance/($500.00 free leads) matching your initial deposit which means a total of $1000.00 deposit towards your leads.
HOW TO PAY
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TESTIMONIALS
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John Willcox
Boise, Idaho
"I love how easy it was to set up my account through QuotesMonkey.com, easy, affordable and great customer service... no need to shop with any others quotesmonkey is the best lead company by far."
Phil Kingston Insurance
Orlando, Florida