FE Medical History Form

[SrSvcs]

Looking for a somewhat generic medical history form for FE clients. Agentguy5 had a good one, but I lost it. Thanks for any help.

I know it's easy to construct my own, I just don't want to forget anything.

 

[Baseball7]

Top:
Client Info
1/3/Wed/Bi



Current Insurance Info Section

Health:Yes/No
MI
CA
CVA
Tobacco
Diabetic
And added recently
Kidney/Liver
AIDS/HIV
Dementia


The next section on the page is for med a med list.

5 Points to remember about client
Area for referral info

Then I use the blank back side for quotes.

 

[John Galt]

Looking for a somewhat generic medical history form for FE clients. Agentguy5 had a good one, but I lost it. Thanks for any help.

I know it's easy to construct my own, I just don't want to forget anything.

Here, I added a few things for payment, cc, benefits payment etc to this one, its in word format so you can modify it however you wish:



Direct Link to document: https://www.dropbox.com/s/xw7jbffox4m4sr4/FE Med Hstry Qstns.doc?dl=0

 

[SrSvcs]

Thanks for the help! Perfect.

 

[WinoBlues]

Here are a couple that I use. Not FE only. They are in word so can be changed to taste.

Note: I print them on green paper $ so that I can find it easily in the file. The gold is usually in the notes on the back.

If you improve any of these share the changes.

 

[Newby]

Here's a simple one I made for new FEX agents to just staple their lead at the top and get the main facts quickly on the appointment.

 

[rousemark]

Like the way fact finding was done in the old days... "You don't have anything wrong with you, do you " ? ....... "Write your name here".

 

[WinoBlues]

Like the way fact finding was done in the old days... "You don't have anything wrong with you, do you " ? ....... "Write your name here".

The had no script or mib check FE in the old days???

 

[rousemark]

The had no script or mib check FE in the old days???

Nope.. and when Independent life came out with a ROP plan, the manager told his agents, "Now we can do legally what we have been doing all along".

 

[John Galt]

Nope.. and when Independent life came out with a ROP plan, the manager told his agents, "Now we can do legally what we have been doing all along".