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Please select below the areas and filters you would like.  Areas will be sold on a first-come, first-serve basis.  A representative will send your sign-up form upon receipt of your application.  The base price for health leads is $7.50

 
   
Your Name
Your Phone Number
- -
Your Email
Date you would like to start
Zip Codes you would like (1st three digits)
If you would like an entire state, you may just enter the state name
Filter Requests
     
The base price for the leads is $7.50  
     
Expectant Mother/Father Filter out Yes $1.00  
Smokers Only Smokers $1.00   No Smokers $1.00
Age

Min Age

  20 years old $0.25
  25 years old $0.50
  30 years old $0.75

Max Age

  60 years old $1.50
  65 years old $1.25
  70 years old $1.00
  75 years old $0.75
  80 years old $0.50
  85 years old $0.25

Rated or Declined in last 5 years Filter Out Yes (Must NOT have been rated/declined) $0.50 Filter out No (Must HAVE been rated/declined) $0.50
Had a DUI/DWI in last 5 years Filter Out Yes (Must NOT have had a DUI/DWI) $0.50  
Currently Insured Filter Out Yes (Must NOT be currently insured) $1.00 Filter Out No (Must be currently insured) $1.00
Resident of US/Canada for last 12 months Filter Out No (Must have been resident for 12 months) $0.50  
Major Medical Conditions (You may filter out all conditions or choose only the ones you want to filter individually) Filter out ALL listed below $2.00  
AIDS/HIV $0.25 Alcohol Abuse (last 3 yrs only) $0.25 Alzheimer's Disease $0.25
Cancer (last 10 yrs only) $0.25 Cerebral Palsy $0.25 COPD $0.25
Coronary Artery Disease $0.25 Diabetes Type I $0.25 Diabetes Type II $0.25
Drug Abuse (last 3 yrs only) $0.25 Emphysema $0.25 Epilepsy $0.25
Fibromyalgia $0.25 Heart Attack $0.25 Hepatitis C $0.25
Hypertension $0.25 Kidney Disease $0.25 Kidney Stones $0.25
Liver Disease $0.25 Multiple Sclerosis $0.25 Stroke $0.25
Vascular Disease $0.25    
 
Any additional filter requests or comments
   

 
 
 
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