Open Hours: Mon – Fri: 08 am – 5 pm, Sat: 8 Am -Noon Sunday: CLOSED

shape

Policy proposal

Please fill out and submit the form below. Our representative will inform you about other requirements for
obtaining an insurance policy:

    Select City:

    Your Full Name:

    Father’s/Husband’s Full Name:

    Indentity No:

    Date of Birth:

    Residential Address:

    Contact No:

    Fax:

    Email:

    Your Occupation:

    Monthly Income:

    Chose Plan:

    Chose Terms:

    Do you have any physical impairment? If yes, please state its nature:

    Do you now or ever had heart disease, diabetes, high blood pressure, TB, jaundice or liver, stomach, renal disease, cancer, asthma, epilepsy, nervous or psychological disorders? If so specify with dates:

    Are you in good health? If not, describe the nature of ailment:

    Aliqua id fugiat nostrud irure ex duis ea quis id quis ad et. Sunt qui esse pariatur duis deserunt.

    Contact

    Open Hours

    Mon – Sat: 8:00 am to 6:00 pm Sunday: Closed

    Gallery

    © All Copyright 2023 by Ferrum Insurance Designed by Mikew Wachira +254-722-626078