Home Insurance Quote Intake
Property, security, history, and cover wants – the quote request that quotes itself.
6 questions · 1 page · about 2 minutes to answer · fully editable after you start
Home quotes need facts customers resent typing twice. This intake collects them once, in a tolerable order: property basics, security and risk factors, claims history in honest bands, and the cover priorities – contents-heavy, high-value items, accidental damage – that route the enquiry to the right product rather than the default one.
The cover-priorities question is the differentiator: quoting what the customer actually cares about, first, beats racing to the cheapest headline premium.
Template preview
This is a picture of every question as a respondent would see it, so nothing on it can be clicked or typed into. Use this template to get your own editable copy.
Opens in the Classic theme, or in your own default theme if you have set one — change it anytime to any of the 4 built-in looks, or build your own on a paid plan.
Page 1
About your home
This form asks about your home and your contact details. We use your answers to prepare a home insurance quote. It takes about 2 minutes. If you need help with a specific policy or claim, please contact us directly, as this form may not be read straight away. Please do not include card numbers or passwords.
Q1.The property and your contact details*
Q2.Property type*
- Detached
- Semi-detached
- Terraced
- Flat/apartment
- Non-standard construction
Q3.Security fitted
- Standard locks
- Alarm
- Alarm + cameras
- Gated/concierge
Q4.Claims in the last 5 years?*
- None
- One
- Two or more
Q5.What matters most in your cover?
- Lowest premium
- High-value items covered properly
- Accidental damage included
- Low excess
- Alternative accommodation cover
- Other…
Q6.Cover start date needed*
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