Special Risk Bureau
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Personal Details Questionnaire (PDQ)

 
All applications start by completing the PDQ. Remember to get your client's signature(s) on the signature page. If you want medical details to be seen only by the underwriters please contact us and we can advise you how this can be done.
 
Personal Details Questionnaire (PDQ)
For use with all Life and Critical Illness applications

 

 

Supplementary Questionnaires

 
If you have answered yes to a question that requires a supplementary questionnaire, please complete the relevant form from the list below.
 
  Financial
 
Fin 01 - Financial
 
  Medical
 
Med 01 - Anxiety
Med 02 - Arthritis
Med 03 - Asthma
Med 04 - Back Probs
Med 05 - Bladder
Med 06 - Diabetes
Med 07 - Drugs
Med 08 - Epilepsy
Med 09 - Growths
Med 10 - Gynaecological
Med 11 - Joints
Med 12 - Migraine
Med 13 - Stomach
Med 14 - Thyroid
Med 15 - BP/Cholesterol/Heart
   
  Occupational
 
Occ 01 - Fishing
Occ 02 - HM Armed Forces
Occ 03 - North Sea
   
  Pastime
 
Pst 01 - Aviation
Pst 02 - Diving
Pst 03 - Hang Glide
Pst 04 - Motor Sports
Pst 05 - Mountaineering
Pst 06 - Parachuting
Pst 07 - Potholing
Pst 08 - Power Boats
Pst 09 - Residency
Pst 10 - Yachting
   
 

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