Lead Type: Health Insurance
Date Received: 11/07/2006
Contact Infomation:
Name: Bobby Marsh
Address: 165 Cravey Place
City: Atlanta
State: GA
Zip: 30345
Primary Phone: (770) 493-8300 Day,Evening
Alternate Phone: (770) 551-4600 Day,Evening
Email: marshmellowed1970@earthlink.net
Insured Information:
Sex dob Height Weight
------- ---------- --------- ---------
Primary: Male 05/28/1970 5'11" 265
Spouse: Female 07/22/1974 5'4" 200
Child 1: Male 04/16/1998
Child 2: Male 10/17/1996
Child 3:
Child 4:
Insureds that currently use tobacco: My spouse
Currently Insured: No
If insured, carrier name:
Self Employed: No
Occupation: My husband is a truck driver
Policy Information:
Full Time Student: No
Duration of Coverage needed: More than 6 months
Diabetes: No
Date Coverage needed: ASAP
Health Conditions, Medications, and Other Information:
Is anyone to be covered currently pregnant? No
Other Health Conditions and Information:
Asthma
The youngest child has asthma. He was diagnosed at 2 months and is on singulair, abuterol and pulmicort(daily).He is also on Orapred or Predisone when needed.
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