Tobacco use includes the following: Any cigarettes including vapor cigarettes Pipe smoking regardless of use Cigars including celebratory (include explanation in memo at the end of form) Snuff, chew or chewing tobacco

* If Shared Care is selected spouse/partner benefit selections will be the same. You also have to select Spouse/Partner both applying under marital status on the client information page.

Any additional information you feel necessary to create the quote.