Section 1: Business Information
(Helps LISS understand who the client is)
Name
*
First Name
Last Name
Company/Agency Name
*
E-mail
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Business Location (City, State)
*
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Section 2: About Your Insurance Agency
(Helps identify what kind of tasks the VA should handle)
What type of insurance does your agency offer?
*
Auto
Homeowners
Commercial/Business
Life
Health
Others (please specify)
How many agents or team members do you currently have?
*
1—3
4—10
11—20
20+
Do you have any VAs or remote staff?
Yes
No
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Step 3: VA Role and Requirements
(Clarifies the tasks and qualifications needed)
What tasks or responsibilities do you want your VA to handle?
*
Sales and Lead Follow-ups
Renewals and Retention Support
Quoting and Policy Setup
Billing and Payments
Data Entry/CRM Management
Appointment Setting
Cold Calling
Others (please specify)
Which management systems or CRMs does your agency currently use? (e.g., Saleforce, EZLynx, AMS360, NowCerts, etc.)
What time zone or schedule do you want your VA to work?
US Business Hours
Flexible
When would you like your VA to start?
-
Month
-
Day
Year
Date
Additional notes or special requirements:
Submit
Should be Empty: