[EXAMPLE WEB LEAD] FamSure - Web Lead Example

LIFE INSURANCE · 4 QUICK QUESTIONS

What would you like life insurance to help cover?

Let's find coverage options that fit your needs.

Join 100,000+ people who have explored their life insurance options.

How much life insurance coverage are you looking for?

Not sure how much coverage you need? That's okay!

What state do you live in?

Life insurance options vary by state. Your answer helps us personalize your coverage profile based on where you live.

Preparing Your Personalized Coverage Profile...

Reviewing your coverage preferences

Personalizing your profile for @state

Adding your desired coverage amount

Coverage profile complete!

Your Coverage Profile Is Ready!

Thanks for answering a few quick questions! Here's your personalized coverage profile.

Your Coverage Profile

Age: @age

Coverage Goal: @coverage_reason

Desired Coverage: @coverage_amount

Location: @state

You're One Step Closer to a Personalized Quote!

Continue to complete your life insurance quote request.

Who Should We Prepare Your Quote Request For?

You're almost done! Enter your name and email below to continue.

FINAL STEPS · 1 OF 3

First Name

Please enter your first name

Last Name

Please enter your last name

Email Address

Please enter your email address

Why We Ask: Your name and email help us personalize your quote request and keep you updated on next steps.

What's the Best Number to Reach You About Your Quote?

Enter your number below. We'll send you a one-time verification code to securely complete your request.

FINAL STEPS · 2 OF 3

Phone number

Please enter a valid phone number

Why We Ask: We'll send you a one-time verification code to confirm you have access to the phone number provided.

By clicking ‘Send My Verification Code’ I provide my express written consent, via electronic signature, to be contacted by FamSure and its licensed life insurance agents and partners regarding insurance products at the phone number provided, including through automated dialing systems, prerecorded or artificial voice messages, and SMS/text messages, even if my number is on a federal or state Do Not Call list. Consent is not required as a condition of purchasing insurance.

Verify Your Phone Number

We've sent a 4-digit verification code to:

@phone_number

Enter the code below to complete your life insurance quote request.

FINAL STEPS · 3 OF 3

Please specify an answer

Didn't receive your code? Resend code.

You're All Set, @first_name!

Your life insurance quote request has been successfully submitted, and your phone number is verified.

Your Next Step: Watch for a Phone Call!

A licensed insurance agent from one of our insurance partners will be calling shortly to discuss your coverage options and help you get a personalized life insurance quote.

Your agent will call you at: