Request Assistance

Request Assistance

To receive a Long-Term Care quote please complete the form below and a Brokerage Manager will contact you shortly with the applicable quote.

Advisor Information

Client Information

Product Information

Please list any relevant health conditions, hospital visits, surgeries, and medications for the past 5 years.
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IMS associates is here to assist with your LTC Insurance Quote Request. As an innovative Long-Term Care General Agent we will help you place those LTC cases.