Contact Me

If you have any questions or comments about my services, or if you would like to receive the FREE booklet "Should I Buy Long Term Care Insurance?" please feel free to email me by filling out the form below.

You may also call me at 336-760-9660

email ltcmaster@aol.com

 Please complete the following form and submit your information.  You will be contacted by me to answer your questions.

This site employs strictly confidential email.  Your name and information will NOT be given out to ANY mailing lists. 
* ITEMS ARE REQUIRED

Name*:
Date of Birth:
   
Spouses Name:
Date of Birth:
   
E-mail Address*:
   
Street Address*:   
City*:    State*:   Zip* :
   
Contact Phone Number*: Best Time to call: Morning  Afternoon  Evening
   
Please send me the FREE Booklet "Should I Buy Long Term Care Insurance?" Yes  No
   
Please list any additional comments or question you have.

Home  ·    Is LTCI For You   ·   Contact Me

copyright © 2006 LTCIP