Agents

Agent Registration

The majority of the systems for the licensed agents working with us are only accessible with a username and password. Once you are logged-in you will have access to online case status, E-Applications, and the automated resources we make available exclusively to agents doing business with our firm. We invite licensed agents to register to gain access to DisabilityQuotes.com by filling out the information below.

If you have previously had access to DisabilityQuotes.com, please use the First Time Login? instead of the form below.

First Name

Last Name

Password Requirements: One upper, one lower, one number, one special character (*,!,@,#,^), 8 character minimum

Confirm Password

Email Address

Mobile Number

Company

Primary Carrier Affiliation

Street Address Line 1

Street Address Line 2

City

State

Zip

Are you currently appointed by a Guardian agency? NoYes

Have you sold $5,000 or more of Guardian business in the last two years? NoYes