Insurance Quote Intake Forms

New clients came in through referrals, the website, social media, and plain old phone calls. Whatever the source, the first conversation spent a long stretch just gathering basics: who’s in the household, what coverage they have now, which doctors and prescriptions matter.

The agency’s current quote form asks everyone the same questions, whether they’re turning 65 or insuring a 20-person company. Family details arrive as free text, and staff still sort each request by hand before anyone can quote it.

Health details are sensitive, so the design started with limits. Medicare shoppers are never asked health-history questions. Those conversations stay with the agency. Sensitive questions are optional, and every page shows the office phone number and a link to book a call.

We also chose not to build custom software. Configuring a commercial form platform in the agency’s own account fit the job, and it gives the agency something it controls directly.

The questions follow the carriers’ own applications, and the layout follows published form-design research from government and usability sources. The agency’s earlier online form had broken when someone edited it live, so this one is generated from a single source file and changed in one place.

The first question asks what the visitor is shopping for: individual health coverage, Medicare, dental and vision, group benefits, or a not-sure option. Only the pages for that path appear. Nine pages exist in total, and nobody sees all of them.

Every path was tested forward and back. Testing caught a phone field that garbled pasted numbers and a ZIP code field that accepted two digits, and both were fixed.

1. 01Medicare shoppers skip health history entirely.
2. 02Sensitive questions include an option to talk about it on the call instead.
3. 03Every page shows the office phone number and a link to book time.
4. 04The form stops at what a quote needs. It never asks for a Social Security number, Medicare number, street address, or policy number.

The intake is built and tested. It goes live once the agency signs off on the wording and the remaining setup is done.

Possible next phases include an automatic handoff into the agency’s management system and an assistant for routine client questions. Neither exists yet.