Take 60 seconds. Answer a few easy questions.

Getting life insurance shouldn’t feel like a chore. With TaraVita, it doesn’t.

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What is your full name?

What province do you live in?

What is your date of birth?What is your sex?

Male Female

Are you a smoker? (Non-smoker = No tobacco/nicotine in the last 12 months)

Yes No

How many alcoholic drinks do you consume per week?

In the past 2 years, have you used recreational drugs (e.g., marijuana, cocaine, etc.)?

Yes No

Have you ever been diagnosed with or treated for cancer (other than basal cell skin cancer), heart disease, heart attack, or stroke?

Yes No

Have you ever tested positive for HIV or been diagnosed with AIDS?

Yes No

Have you been hospitalized or had surgery in the last 12 months?

Yes No

Have you been diagnosed with a terminal illness or been given less than 2 years to live?

Yes No

Have you ever been treated for or advised to seek treatment for alcohol or drug abuse?

Yes No

Have you been diagnosed with Alzheimer’s, Parkinson’s, ALS, or other degenerative neurological disorders?

Yes No

Do you have diabetes and have experienced complications like neuropathy, retinopathy, or kidney disease?

Yes No

Have you been declined for life insurance in the past 12 months?

Yes No

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