Wendt Insurance Group

We appreciate you taking the time to give us the information that helps us serve you better.

First Name *

Last Name *

Email *

Phone *

City *

State *

Postal code *

What is your Date of Birth? *

What type of insurance can we help with today? *

Health & Life

Commercial Property & Business

Auto & Home

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from Wendt Insurance Group. Message & data rates may apply. You can reply STOP to unsubscribe at any time.

You selected Health and Life, further narrow the area we can assist with. *

Indvidual Health & Life Insurance

You are an Employer looking for options for your Organization

How many, including yourself is in your household? This is anyone that is included on your taxes as a spouse or a dependant. *

Are you married? *

Yes

No

If you are married or have dependants please list them below with gender, relationship and age.

What is your Annual Gross Household Income? (Before Taxes) *

Comapny Name *

Nature of Business: *

Years in Business: *

Number of Employees: *

What best describes the reason for wanting a Quote for your organization? *

No Existing Health Benefits and Exploring Options

Existing Health Benefits and Shopping Around

Seeking Business Insurances: Commerical Auto, Liability Etc.

Current Insurance Provider (if applicable):

In your own words describe what you want to explore for your Organization: *

Due to Needing sensitive information a representative will call to finalize quote and coverages.

What product can we quote for you? *

Auto

Home

Auto & Home

Best Time To Call? *

Morning

Afternoon

Evening After 5pm

How many licensed Drivers in household?

How many vehicles?

Do you require a SR-22? *

Yes

No

Address

Street Address *

City

State

Thank You for Reaching Out!

We appreciate the opportunity to assist you with your insurance needs and are committed to providing you with the best possible service.

Our team at Wendt Insurance Group is reviewing your submission and will be in touch shortly to provide personalized options tailored to your needs. If you have any immediate questions, please don’t hesitate to contact us at

We look forward to helping you find the right coverage and ensuring your peace of mind. Thank you for choosing Wendt Insurance Group—we’re here to protect what matters most to you!

Office: Serving IN, OH, KY, TN,

Call 317.956.2468

Email:[email protected]

Site: www.wendtins.com