Pre-Qualification Forms

If you would like to see illustrations at our first meeting, please complete the appropriate pre-qual form and email Carly to request a link to upload them securely. If you don’t complete the pre-qual form, these are the types of questions we will be asking.

LTCI Pre-Qual Form

Long-Term Care Form

Looking for long-term care insurance? Use this convenient fillable PDF form to contact Carly and start discussing your eligibility, pricing, and options. Please email this form to carly@cjbins.com or reach out for an encrypted link.

Life Pre-Qual Form

Life Insurance form

Looking for life insurance? Use this convenient fillable PDF form to contact Carly and start discussing your eligibility, pricing, and options. Please email this form to carly@cjbins.com or reach out for an encrypted link.

You may email the completed form to Carly@cjbins.com or contact her to request an encrypted link to upload the files.

From Our Clients

Testimonials from our clients who have worked with CJB Insurance Services.

Carly at CJB has been simply wonderful to work with. She is unique in that she really takes time to understand needs and worked primarily to educate us on the different paths, options and scenarios serving as a guide. I never once felt that she wanted us to buy a policy, which I think is always commendable.

Aaromal S.

San Francisco, CA

Carly was incredibly helpful for us in both understanding our options and shopping for life insurance policies. Her communication was great– we never felt hurried or pressured, and she was available to answer questions and talk through how to approach our goals. Strongly recommend!

John S.

San Francisco, CA

I went to Carly for Long-Term Care Insurance because I don’t want to be a burden on my family, but I was overwhelmed. Carly broke things down and explained the details so that I felt comfortable with my decision. I’m so happy to have an affordable plan that will help me in my later years.

Monique D.

Charlotte, N.C.

Ready to secure your future?

CJB Insurance Services is here to help you and your loved ones plan for the future.