Insurance Quote Request Form
Multi-line quote intake for auto, home and life cover with routing to the right question set.
A ready-to-use finance, insurance & tax form for advisers, brokers and finance teams: 19 questions, 3 pages, 6 conditional rules.
- Questions
- 19
- Pages
- 3
- Layouts
- classic · card
- Conditional rules
- 6
- Typical time
- 6 min
Searches this template answers
- insurance quote form
- auto insurance quote request
- home insurance quote form
- life insurance quote intake
- multi line insurance form
- insurance broker lead form
Also filed under
Live preview and test console
This is the real form. Answer it to test the 6 conditional rules — nothing is sent or stored.
Page 1 of 3 — Get a quote
Every question on this page is currently visible.
What happens after submit: nothing is stored in this preview. On your own copy, every response triggers an instant email notification and lands in your response dashboard, ready to export or forward.
Happy with it? Take a copy into your workspace — every question, rule and setting comes with it.
Who this template is for
Insurance Quote Request Form is built for advisers, brokers and finance teams who need to collect structured financial detail with a clear audit trail.
- Advisers, brokers and finance teams working in finance, insurance & tax.
- Teams who need to collect structured financial detail with a clear audit trail without writing code or paying for a custom build.
- Anyone replacing incomplete applications that fail compliance review with one structured record per enquiry.
- Respondents are clients and applicants — the form asks them 19 questions across 3 screens.
- Mobile-heavy audiences, thanks to the one-question-per-screen card layout.
Why this form is useful
It removes the cost of incomplete applications that fail compliance review and turns each submission into a record your team can act on immediately.
- 5 questions are required, so submissions arrive complete instead of needing a follow-up email.
- It collects a verified email address so replies and confirmations land.
- It captures a phone number for urgent follow-up.
- It pins the request to a specific date.
- It captures a numeric value you can filter and sort on.
- Conditional logic hides 6 questions until they are relevant — shorter forms convert better than long ones.
- Splitting the form across 3 pages keeps each screen short and shows respondents how much is left.
- Every response is stored, searchable and exportable, so nothing depends on one person's inbox.
How to use this template
From copy to live form is a few minutes of work, and every step is reversible.
- 1Press “Use this template” — a fresh copy of Insurance Quote Request Form lands in your workspace, ready to edit.
- 2Rename or delete any question, and change what is required. Nothing here is fixed.
- 3Open Notifications and add the email addresses that should be alerted on each submission; add an auto-reply to the respondent if the form collects an email address.
- 4Publish it, then either share the link directly or paste the embed snippet into your site — the embedded form resizes to fit and loads no marketing or advertising trackers.
- 5Watch responses land in Submissions, where you can filter, label and export them to CSV or PDF.
Logic and conditions blueprint
Exactly how this form behaves as it is answered — 6 conditional rules ship with it.
- Features advanced show logic: if “Which type of cover are you requesting a quote for?” is Auto, the form dynamically exposes “Vehicle year, make and model”. Otherwise that question never appears.
- Features advanced show logic: if “Which type of cover are you requesting a quote for?” is Home, the form dynamically exposes “Property type”. Otherwise that question never appears.
- Features advanced show logic: if “Which type of cover are you requesting a quote for?” is Life, the form dynamically exposes “Date of birth”. Otherwise that question never appears.
- Features advanced show logic: if “Do you currently have insurance with another provider?” is Yes, the form dynamically exposes “Current insurer name”. Otherwise that question never appears.
- Features advanced show logic: if “Do you currently have insurance with another provider?” is Yes, the form dynamically exposes “Renewal date”. Otherwise that question never appears.
- Features advanced show logic: if “Would you like a quote for a second line of cover too?” is Yes, the form dynamically exposes “Which additional line of cover?”. Otherwise that question never appears.
- All 6 rules are editable in the Logic tab, and the built-in checker warns about rules that contradict each other.
About this template
One quote form that tries to ask every question for every line of cover ends up long and confusing, so this template routes people to only the fields their chosen line actually needs. It opens with contact details and a line-of-cover picker — auto, home or life — which is the single answer that decides everything that follows. Choosing auto reveals vehicle year, make, model and current mileage; home reveals property type, year built and square footage; life reveals date of birth, smoker status and desired coverage amount. A separate question asks whether the person currently has insurance with another provider, and answering yes opens a field for their current insurer and renewal date, which agents use to time follow-up calls around the actual renewal window rather than guessing. A bundling question near the end asks if they'd like a quote for a second line of cover at the same time, since bundled quotes convert at a noticeably higher rate than single-line ones, and saying yes reveals a short field to note which additional line to include. The form closes with a preferred contact method and best time to call, so the quote can be delivered the way the requester actually wants it rather than by default email blast.
What this form asks
Every question is editable — rename it, make it optional, or delete it entirely.
Page 1 — Get a quote
- Full namerequired
- Email addressrequired
- Phone number
- Which type of cover are you requesting a quote for?required
Page 2 — Cover details
- Vehicle year, make and model
- Current annual mileage
- Property type
- Year built
- Square footage
- Date of birth
- Do you smoke or use tobacco?
- Desired coverage amount
Page 3 — Current coverage and preferences
- Do you currently have insurance with another provider?required
- Current insurer name
- Renewal date
- Would you like a quote for a second line of cover too?
- Which additional line of cover?
- Preferred contact methodrequired
- Best time to call
19 questions in total.
How the form changes as it's filled in
This template ships with 6 conditional rules, grouped into 5 behaviours driven by 3 questions. Everything below is already set up — edit or delete any rule once the template is in your workspace.
Driven by “Which type of cover are you requesting a quote for?”
- Reveals questions
If “Which type of cover are you requesting a quote for?” is Auto, the form reveals “Vehicle year, make and model”.
- Reveals questions
If “Which type of cover are you requesting a quote for?” is Home, the form reveals “Property type”.
- Reveals questions
If “Which type of cover are you requesting a quote for?” is Life, the form reveals “Date of birth”.
Driven by “Do you currently have insurance with another provider?”
- Reveals questions
If “Do you currently have insurance with another provider?” is Yes, the form reveals “Current insurer name” and “Renewal date”.
Driven by “Would you like a quote for a second line of cover too?”
- Reveals questions
If “Would you like a quote for a second line of cover too?” is Yes, the form reveals “Which additional line of cover?”.
Set it up step by step
- 1
Route by line of cover automatically
Send auto requests to your auto-line queue and life requests to a licensed life agent instead of a single shared inbox.
- 2
Call renewal-window leads first
Prioritise anyone who listed a renewal date within the next 30 days — they're the most likely to actually switch.
- 3
Follow up bundling requests same day
Bundled quotes have a short attention window; quote both lines together before the requester gets a quote elsewhere.
- 4
Confirm contact preference before calling
Respect the stated contact method — a phone call to someone who asked for email creates a bad first impression.
Mistakes to avoid
- Asking every applicant every question regardless of line of cover, which makes the form feel twice as long as it needs to be.
- Ignoring the current-insurer and renewal-date answers, missing the best window to actually win the switch.
- Not asking about bundling, leaving a second-line sale on the table that the requester would have said yes to.
What it pairs with
Most teams don't run this form on its own. These are the forms and systems it sits next to.
What to do with the responses
Route the submission to the right specialist by line of cover, prioritise renewal-window leads, and prepare a bundled quote whenever the second-line question was answered yes.
Works in both layouts
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Privacy & compliance
This form collects identity or financial details. Enable encrypted answers on the sensitive fields, avoid emailing full values in notifications, and delete responses once the check is complete.
Frequently asked questions
Can I add more lines of cover, like commercial or renters?
Yes — add another option to the cover-type question and a matching show/hide rule for its detail fields.
Why ask about mileage for an auto quote?
Annual mileage materially changes premium estimates, so collecting it upfront avoids a callback just to ask that one question.
Is this a substitute for a formal insurance application?
No — this is a quote request to start a conversation. The formal application and underwriting happen separately once a rate is agreed.
Should the smoker question be required?
Keep it optional here since it only affects life quotes, but flag incomplete life-cover answers before generating a rate.
Is the Insurance Quote Request Form template free to use?
Yes. You can preview and test Insurance Quote Request Form on this page without an account, and take a copy into your own HelloForms workspace on the free plan. There is nothing to install and no card required to publish it.
What does the Insurance Quote Request Form template ask for?
It asks 19 questions across 3 pages, 5 of which are required. Every question is listed in full further down this page, and each one can be renamed, reordered, made optional or deleted after you copy the template.
Can I edit the Insurance Quote Request Form form after copying it?
Yes — the copy is entirely yours. Change wording, add or remove questions, switch between the classic and card layouts, restyle it to match your brand, and set who gets notified on each submission.
How does the conditional logic in this finance, insurance & tax form work?
6 conditional rules ship with the template: Features advanced show logic: if “Which type of cover are you requesting a quote for?” is Auto, the form dynamically exposes “Vehicle year, make and model”. Otherwise that question never appears. Features advanced show logic: if “Which type of cover are you requesting a quote for?” is Home, the form dynamically exposes “Property type”. Otherwise that question never appears. Features advanced show logic: if “Which type of cover are you requesting a quote for?” is Life, the form dynamically exposes “Date of birth”. Otherwise that question never appears. All rules are editable in the Logic tab.
Where do responses to the Insurance Quote Request Form form go?
Submissions land in your workspace under Submissions, where you can search, filter, label and export them to CSV or PDF. You can also email a notification to your team on every submission and send the respondent an auto-reply.
Can I embed the Insurance Quote Request Form form on my own website?
Yes. Publish the form and paste the embed snippet into any page or share the direct link. The embedded form resizes to fit its container and loads no advertising or marketing trackers inside the iframe.
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