Authorization and Release Forms

Preliminary Inquiry Form and HIPAA Authorization. This form allows FBL to release an underwriting file to Creekmore. Instructions for FBFS agents are on the first page of the form.

Simplified Issue / Limited Medical Questions – United Home Life

UHL has term and whole life available with limited medical questions. Review the application for specific questions the client must answer.

Click here for information on UHL products. Select your state and enter the password “colts”.

ALL APPLICATIONS AND APPOINTMENT PAPERWORK MUST BE SENT TO CREEKMORE INSURANCE GROUP. Call (800) 359 – 5102 x 354 if you need help with UHL products.

Guaranteed Isssue – Presidential – Graded Benefit Whole Life

No medical questions.

Available from $5,000 to $50,000 in most states

• State Approval Grid
• GBL Brochure – Agent
• GBL Brochure – Client
• Rate Calculator (Excel spreadsheet)

For more information, contact

Matthew A. Treskovich, MBA, CMA, CLU, ChFC, FLMI
Creekmore Insurance Group, Inc.
Toll Free: (800) 936-0339 x 354

365 Aulin Ave
Oviedo, FL 32765