ARAG Plan Intake Form

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URL

This field is for validation purposes and should be left unchanged.

Validation Code

Provided by your Estate Plan HQ Intake Specialist. Required to continue.

Plan Selection

Please choose your plan details. This section unlocks with your Validation Code.

Name*

First Last

Which Plan Do You Want?*

Select the plan you'd like ARAG to cover.

Solo or Couple?*

Is this plan for just you or for a couple?

Additional Information or Notes

Tell us anything else you'd like us to know about your estate planning needs.

Terms & Authorization

Please review and confirm below.

By submitting this form, you authorize Estate Plan HQ to prepare your estate planning documents using the information provided. You understand that Estate Plan HQ will bill ARAG directly for this service. You will not be required to pay Estate Plan HQ directly if ARAG confirms your coverage.

ARAG Agreement*

I confirm the information above is accurate and I authorize Estate Plan HQ to prepare my plan and bill ARAG directly.

Agreement to Terms*

I have read and agree to the Estate Plan HQ Engagement Terms.

Please review our Engagement Terms before agreeing.

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