Life Insurance Protection ReviewLife Insurance Protection Review™Protecting your family starts with understanding the numbers. Complete this brief review to help Dr. Campbell Taxes and Life Insurance understand your current situation, determine whether we can currently serve your state, and identify the areas you may want to discuss during a Protection Review. This is not an insurance application and does not obligate you to purchase coverage.Tell Us About YouFirst NameLast NameEmailPhone/MobilePlease select the state where you currently reside. Life insurance availability is based in part on state licensing and carrier availability.State of Residence– Select –AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingLet’s Look at Your Protection NeedsGood news. Based on the state you selected, Dr. Campbell Taxes and Life Insurance may currently be able to assist you. The following questions will help us understand what you are trying to protect.Do you currently have life insurance? Yes — personally owned coverage Yes — through my employer Yes — both personal and employer coverage No I’m not sureWhat caused you to request a Protection Review today?I am concerned my family may not have enough protectionI only have life insurance through workI do not currently have life insuranceI have life insurance but do not know if it is enoughMy family situation recently changedMy income recently changedI purchased or refinanced a homeI own a businessI am interested in permanent/cash-value life insuranceI am interested in learning about IULI want to review an existing policyOtherWho currently depends on you financially? Spouse Children Aging parents Other family members Business partners/employees No one currently depends on my incomeWhich financial responsibilities are most important for you to protect? Household income Mortgage or rent Everyday household expenses Debt Children’s needs Education Final expenses Retirement goals for my spouse Business obligations Legacy/inheritance OtherApproximately how much annual income do you personally contribute to your household?– Select –Under $25,000$25,000–$49,999$50,000–$74,999$75,000–$99,999$100,000–$149,999$150,000–$249,999$250,000+Prefer to discuss during my reviewWhich best describes your current housing situation? Own — mortgage Own — mortgage paid off Rent OtherDo you have children or other dependents whose future expenses you want to protect? Yes No Not sure / let’s discussWhat future needs concern you most? Everyday support Childcare Education Remaining in the family home OtherDo you know approximately how much life insurance you currently have? Yes I have coverage but don’t know the amount I think I know I do not currently have coverageApproximate Current Coverage Under $50,000 $50,000–$99,999 $100,000–$249,999 $250,000–$499,999 $500,000–$999,999 $1 million+ Prefer to discuss privatelyWHAT DO YOU WANT TO ACCOMPLISH?What would be most helpful to you right now? Determine how much protection my family may need Review the life insurance I already have Compare my employer coverage with my family’s needs Learn about term life insurance Learn about permanent life insurance Learn about IUL Discuss business protection Discuss legacy planning I’m mainly gathering information right nowREADINESSWhen would you like to address this? As soon as possible Within the next 30 days Within the next 1–3 months I’m researching right nowCONTACT PREFERENCEHow would you prefer that we contact you? Phone Text EmailBest time to reach you Morning Afternoon EmailCONSENT I agree that Dr. Campbell Taxes and Life Insurance may contact me by the phone number and/or email address I provided regarding my requested Life Insurance Protection Review. I would also like to receive educational information from Beyond the Tax Return™ about taxes, life insurance, family protection, and financial planning.Thank You for Your InterestThank you for your interest in a Life Insurance Protection Review. Based on the state you selected, Dr. Campbell Taxes and Life Insurance is not currently able to offer life insurance services in your state. If you would like, we can notify you if service becomes available in your state in the future. Yes. Please notify me if Dr. Campbell Taxes and Life Insurance becomes available in my state. I would like to receive educational content from Beyond the Tax Return™.Submit Form