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First Name

Last Name

Title

Company

Email

Address One

Address Two

City

State

Country

Company Size

Have you ever heard of legal insurance before? Yes No

Do you know who ARAG is? TrueFalse

Do you currently offer voluntary benefits? Yes No

Do you currently offer legal insurance? YesNo

Are you currently involved in the selection or administration of benefits at your organization? Yes No

Do you currently work with a broker? No, I do not work with a broker. Yes, I work with a broker, but do not want you to contact them. Yes, I work with a broker and it is okay if you contact them.

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