Questionnaires for medical impairments/avocations

Kristie Carlsen is MVP’s Director of Underwriting. To help her more accurately review your case, please complete the appropriate form below.

You may also email your underwriting questions to or fax to your local MVP office.

Quote the Right Class the First Time* – Complete this General Info Underwriting Criteria Questionnaire or a more comprehensive questionnaire: Preliminary Medical History Form.

For Specific Impairments, a number of Online forms are available here:

Click Here for Online Questionnaire Builder

Or, complete and return one of the PDF Versions below:

*Results may vary and are not guaranteed. The Underwriting Criteria Questionnaire is intended as a tool to guide advisors to more realistic underwriting expectations and lead the application process.