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If you have NOT been treated or diagnosed with the following in the past five years.

• Heart disorder
• Coronary Artery Disease (CAD), Heart Attack, or a heart procedure 
• Stroke, Transient Ischemic Attack (TIA) or Carotid Artery Disease
• Crohn’s Disease or Ulcerative Colitis
• Liver disorders 
• Kidney disorders
• Emphysema, Chronic Obstructive Pulmonary Disease (COPD)
• Diabetes or Prediabetes
• Cancer, Tumor, Lump, or Mass
• Alcoholism, Alcohol or Chemical Dependency, or Drug or Alcohol Abuse
•  Neck or Back Disorder, Joint Replacement 
• Bipolar Disorder or Schizophrenia
• Systemic Lupus Erythematosus or Multiple Sclerosis (MS)
• Received medical or surgical treatment, consulted a health care professional, or has medication been prescribed or recommended for Acquired Immune Deficiency Syndrome (AIDS) or tested positive for Human Immunodeficiency Virus (HIV)

In the past twelve months:

Been recommended or scheduled for testing (excluding routine), treatment, follow-up, or surgery that has not been completed?

or consulted a health care professional for signs and symptoms of a medical condition for which a diagnosis has not been determined or a final diagnosis has not been communicated or determined

CLICK HERE TO QUOTE

If you have been treated or diagnosed with Diabetes Type 2 but have NOT experienced any of the following in the past 5 years:

• Heart disorder
• Coronary Artery Disease (CAD), Heart Attack, or a heart procedure 
• Stroke, Transient Ischemic Attack (TIA) or Carotid Artery Disease
• Crohn’s Disease or Ulcerative Colitis
• Liver disorders 
• Kidney disorders
• Emphysema, Chronic Obstructive Pulmonary Disease (COPD)
• Diabetes or Prediabetes
• Cancer, Tumor, Lump, or Mass
• Alcoholism, Alcohol or Chemical Dependency, or Drug or Alcohol Abuse
•  Neck or Back Disorder, Joint Replacement 
• Bipolar Disorder or Schizophrenia
• Systemic Lupus Erythematosus or Multiple Sclerosis (MS)
• Received medical or surgical treatment, consulted a health care professional, or has medication been prescribed or recommended for Acquired Immune Deficiency Syndrome (AIDS) or tested positive for Human Immunodeficiency Virus (HIV)

In the past twelve months:

Been recommended or scheduled for testing (excluding routine), treatment, follow-up, or surgery that has not been completed?

or consulted a health care professional for signs and symptoms of a medical condition for which a diagnosis has not been determined or a final diagnosis has not been communicated or determined

CLICK HERE TO QUOTE

I HAVE been diagnosed or treated with one of the following in the past 5 years:

• Heart disorder
• Coronary Artery Disease (CAD), Heart Attack, or a heart procedure 
• Stroke, Transient Ischemic Attack (TIA) or Carotid Artery Disease
• Crohn’s Disease or Ulcerative Colitis
• Liver disorders 
• Kidney disorders
• Emphysema, Chronic Obstructive Pulmonary Disease (COPD)
• Diabetes or Prediabetes
• Cancer, Tumor, Lump, or Mass
• Alcoholism, Alcohol or Chemical Dependency, or Drug or Alcohol Abuse
•  Neck or Back Disorder, Joint Replacement 
• Bipolar Disorder or Schizophrenia
• Systemic Lupus Erythematosus or Multiple Sclerosis (MS)
• Received medical or surgical treatment, consulted a health care professional, or has medication been prescribed or recommended for Acquired Immune Deficiency Syndrome (AIDS) or tested positive for Human Immunodeficiency Virus (HIV)

In the past twelve months:

Been recommended or scheduled for testing (excluding routine), treatment, follow-up, or surgery that has not been completed?

or consulted a health care professional for signs and symptoms of a medical condition for which a diagnosis has not been determined or a final diagnosis has not been communicated or determined

CLICK HERE TO QUOTE