CONSULT WITH OUR PRO!

Following are questionnaire's specific to common conditions.
They will help you gather the information you need to start the processing of your impaired risk case.
If your clients' condition is not on this list, please use this General Use Questionnaire.

• Addison's Disease
• Alcohol / Drug Use
• Alzheimer's
• Aneurysm
• Ankylosing Spondylitis
• ARTHRITIS:
  - General Arthritis Questionnaire
  - Psoriatic Arthritis
  - Rheumatoid Arthritis
• Autism / Asperger's Syndrome
• Barrett's Esophagus
• BPH (Benign Prostate Hyperplasia)
• Bipolar
• BLOOD DISORDER
  - High Blood Pressure
  - Hemochromatosis
  - Hemophilia
• CANCER
  - General Cancer Questionnaire
  - Breast Cancer
  - Colon Cancer
  - Leukemia
  - Melanoma / Skin Cancer
  - Ovarian Cancer
  - Prostate Cancer
  - Testicular Cancer
  - Thyroid Cancer

• CARDIAC
  - Atrial Fibrillation
  - Cardiomyopathy
  - Coronary Disease
  - Heart Bypass / Angioplasty / Stent
  - Heart Valve
  - Irregular Heartbeat
• Celiac Disease
• Cerebral Palsy
• Chronic Fatigue Syndrome
• COVID-19 (Coronavirus)
• Criminal History
• Crohn's Disease / Colitis / Diverticulitis
• Cushing's Disease
• Depression / Anxiety
• Diabetic
• Epilipsy / Seizure Disorder
• Felony
• Gastric Bypass
• Grave's Disease
• Guillain-Barre Syndrome
• HAZARDOUS ACTIVITIES
  - Aviation
  - Climbing
  - Racing
  - Scuba Diving
  - Skydiving
  - Travel
• Hepatitis
• Hodgkins / Non-Hodgkins Lymphoma
• Huntington's Chorea
• Hypopituitarism

• KIDNEY
  - Kidney Disease
  - Polycystic Kidney Disease
• Liver Enzyme Elevation
• Lupus
• Lyme Disease
• Multiple Sclerosis
• Muscular Dystrophy
• Myasthenia Gravis
• Narcolepsy
• Neuropathy / Peripheral Vascular Disease
• Organ Transplant
• Osteoporosis
• Parkinson's Disease
• Pituitary Adenoma
• Post-Traumatic Stress Disorder
• Respiratory Disorders
• Sarcoidosis
• Schizophrenia
• Sleep Apnea
• Spina Bifida
• Stroke
• Thalessemia
• Tourette's Syndrome
• Von Willebrand's Disease
• Wegener's Granulomatosis