Need Help? Have a Question?
Call us now at 586-604-9669
Randy Palmer
Palmer & Associates
(586) 604-9669

Get a Quote

Fill out the form below to get a quote:

Product Desired:
First Name:
Last Name:
City:
State:
Zip:
Phone:
Email:
Birthday: (MM/DD/YYYY)
Are you taking any current medications?
Height/Weight:
Do you use tobacco products?
Do you have any pre-existing medical conditions?
(If so, please name them)
I confirm the above entered information is correct and accurate.
Type the words you see:
 

Home | About Us | Michigan Health Insurance | Individual Michigan Health Insurance | Michigan Family Health Insurance | Michigan Health Savings Account | Michigan Short Term Health Insurance | Michigan Life Insurance | Michigan Medicare Supplements | Blog | Get a Quote | Contact Us

© Copyright 2024 Palmer & Associates // Michigan Health Insurance Broker. All rights reserved. • (586) 604-9669