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1
Your Details
2
Your Quick Quote
3
Lifestyle Questions
4
Medical Questions
5
Final Price & Payment
Tell us about you
Title
Mr
Mrs
Miss
Ms
Mx
Dr
First name
Last name
Date of birth
Day
Month
Year
What was your assigned sex at birth?
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Male
Female Icon
Female
Why do we need to know this?
Do you currently or have you ever used any tobacco, or nicotine replacement products (including e-cigarettes)?
Cigarette Icon
Regular, occasional or social user
(within the last 12 months)
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Past user
(not within the last 12 months)
No Smoking Icon
Never used
What does this include?
Who would you like to cover?
Just me
Me and my partner
What does this include?
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