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Hannah Wilson
Licensed Agent
Insurance
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Thank you for taking the time to complete this short survery. Your responses will help us improve our services and better understand your needs.
Company name
Name & Position
1. How did you hear about us?
Referral from a friend or family member
Online Search
Social Media
Advertisement (e.g., TV, radio, print)
Employer or professional organization
Other (please specify):
Other
2. What do you currently have for health insurance plan?
None
Name of carrier:
Plan name:
Deductible:
3. What do you like about your current plan?
4. What do you dislike or find challenging about your current plan?
5. Are there any additional benefits you would like included in a plan? (Check all that apply)
Dental
Vision
Life
Other
Other
Any additional comments or suggestions?
Email
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Thank you for your feedback! Your input is valuable to us.
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