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Opportunity Scout Branding and Style Form
Customer Name
Branding Primary Color
Please enter the Hex code for the desired color (ex. #000000)
Logo
Max. file size: 50 MB.
Form Header Instructions Text
The default Header Text is displayed above the field. Enter updated Header Text for each section, if applicable. Leave the field empty to retain the defaults.
Health Information - A little background about your general health will help us deliver a more accurate estimate of your cost for protection
Your Coverage How Much Coverage Do I Need? - Select you desired coverage and review your quotes instantly in the next step!
Submit Your Request - Complete your application by filling the information below. One of our advisors will contact you shortly to complete the setup of our policy
Form Side Instructions
The default Side Instruction Text is displayed above the field. Enter updated Side Instruction Text for each section, if applicable. Leave the field empty to retain the defaults.
Text Color
Please enter the Hex code for the desired color (ex. #000000)
Start Page - Jump Protected in 15 Minutes or less!
Basic Information - Jump start your application and get a quoute NOW by answering just 18 simples questions!
Heatlh Information - Need help? Give us a call and a real person will help walk you through the process in 15 minutes or less 1-800-999-9999
Coverage - Select the policy that is the best fit for you, then submit your request by adding some basic contact information. An advisor will reach out to you shortly to confirm your information and prepare you policy
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