| GoodInsurance |

Request An Appointment

We accept appointments every Tuesday, Wednesday, and Thursday

Scheduling Online

Fill out the information blocks whether you’re a new client or current client, and request a few time slots that you would like for an appointment. We will get back to you within a couple days to confirm an appointment time. Appointments can always be taken directly by calling our office at 701.795.1070

New Clients

Name

First Name

Last Name

Phone

(###)

###

####

Email Address

Reason(s) for Appointment

Medicare Healthcare in Retirement

Under 65 Insurance

Life Insurance

Long Term Care Insurance

Critical Illness/Disability Insurance

Investments

Spouse (if attending)

First Name

Last Name

How did you hear about us?

Appointment Times Requested

Provide 2-3 dates and times on a Tue, Wed, or Thu that you would like an appointment. We will confirm which day/time your appointment will be.

Returning Clients

Name

First Name

Last Name

Phone

(###)

###

####

Email Address

Reason(s) for Appointment

Medicare Healthcare in Retirement

Under 65 Insurance

Life Insurance

Long Term Care Insurance

Critical Illness/Disability Insurance

Investments

Additional Info for the Agent

Add any additional information you would like Bonnie to know about you before your appointment.

Appointment Times Requested

Provide 2-3 dates and times on a Tue, Wed, or Thu that you would like an appointment. We will confirm which day/time your appointment will be.

| GoodInsurance |

Request An Appointment

We accept appointments every Tuesday, Wednesday, and Thursday

Scheduling Online

New Clients

Returning Clients

bonnie Sprecher

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