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Understanding Your Needs — MAV Courtage

Before I can make any recommendation, I need to understand your situation and what you expect from your cover. This form takes about 5 minutes.

First, a few words

This form helps me understand your situation and your needs before recommending the most suitable solution.

Your answers are confidential and used solely for your insurance review. You can amend them at any time by contacting me.

⏱ Estimated time: 3 to 5 minutes

🔒 Data processed in compliance with the GDPR (RGPD) and with French insurance distribution rules (DDA / IDD).

Title

A
B
C

Last name

First name

Date of birth

Nationality

Postal adress

Email

Phone

Marital status

A
B
C
D
E
F
G

Do you have dependent children?

A
B

You are :

A
B
C
D

Your professional situation

What is your professional status? (select all that apply)

What is your profession or main business activity?

In what capacity are you consulting me?

A
B
C