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Ron (BJ) Bjorklund 763-767-9792

Katherine (Kat) Schultz 763-458-4179

Joan (Joannie) Moore 952-201-7050

 

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Name *
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Date of Birth (month/ day/year *
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Coverage needed $5,000-$5,000,000 *
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Are you presently taking medication for blood pressure, or does your blood pressure exceed 135/80? * Yes
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Are you presently taking medication for cholesterol, or does your cholesterol exceed 210? * Yes
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