Licensed life insurance agency · CA Lic. #4454050 · NPN 21547111 Call or text (951) 666-2404 · Mon–Fri 9–7 · Sat 9–5 · Sun 9–2
Free pre-qualification · About 3 to 5 minutes

See which coverage you qualify for.

Answer a few questions about your health and lifestyle. Brian reviews them against the guidelines of the insurance companies he works with, then calls you with the options you're most likely to be approved for, before you ever fill out an application.

  • No Social Security number
  • No cost, no obligation
  • Doesn't affect your credit

Your answers

Step 1 of 5
What kind of coverage are you looking for?
A little about you
Sex assigned at birth Insurance companies price life insurance using this. It's only used for your rates.
Your BMI–Enter your height and weight.
Tobacco and medications
Have you used tobacco or nicotine in the last 5 years? (cigarettes, vape, cigars, chew, pipe, patch or gum)
Prescription medications you take now (optional, but it helps the most)
Health history

Have you ever been diagnosed with or treated for any of these? Tap Yes to add a short detail. Honest answers help us point you to companies that are likely to approve you.

Heart disease, heart attack, stent, bypass or heart failure
Stroke or TIA (mini-stroke)
Cancer (other than basal or squamous cell skin cancer)
Diabetes or pre-diabetes
COPD, emphysema, or uses oxygen (CPAP for sleep apnea doesn't count)
Kidney disease or dialysis
High blood pressure
High cholesterol
Depression, anxiety, bipolar or another mental health condition
Sleep apnea
Stayed overnight in a hospital in the last 2 years
Live in a nursing home, receive hospice or home health care, or need help bathing, dressing or eating
Any other condition, surgery or test a doctor has recommended
Driving, record and activities
DUI/DWI, or a suspended or revoked license, in the last 10 years
Felony conviction, or currently on probation or parole
Pilot or student pilot, skydiving, scuba, racing, climbing or a dangerous job
Where should Brian send your options?
Your privacy
  • We never ask for your Social Security number on this form.
  • Your answers are used only to find coverage you're likely to qualify for, and they're shared with an insurance company only if you decide to apply.
  • This is not an application for insurance and not an offer of coverage. The insurance company makes the final decision on eligibility and price after reviewing a completed application.

By submitting, you ask Walker Agency LLC to contact you about the coverage you asked about by phone and email. Checking the consent box on step 1 is optional and gives Walker Agency LLC your permission to call and text you, including with automated technology or prerecorded messages; you can opt out any time by replying STOP or telling us. See our Privacy Policy and SMS Terms.

1. You answerHealth, tobacco, medications and the coverage you want. About 3 to 5 minutes.
2. Brian reviewsAs an independent agency, we compare your answers with multiple insurance companies' guidelines.
3. You chooseBrian explains your likely options and prices in plain English. You decide if you want to apply.

Brian Walker | Walker Agency LLC | CA Lic. #4454050

This questionnaire is not an application for insurance and is not an offer or guarantee of coverage. Any estimate of which policies you may qualify for is preliminary. Final eligibility, rate class and premium are decided by the insurance company after it reviews a completed application, which may include prescription, medical and other records.

We do not collect Social Security numbers on this form. Your answers are used only to help find coverage that fits you. See our Privacy Policy.

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