Privacy Disclosure and Consent Notice
By submitting this form, you acknowledge and agree that the personal information provided herein, including but not limited to your name, contact information, date of birth, and any health or financial details, will be collected and used solely for the purpose of generating an insurance quote on your behalf.
Your information will be shared with Guerrero Insurance Group LLC and with insurance companies or underwriters only for quoting purposes. It will not be sold, rented, or disclosed to third parties for marketing purposes or for any other purpose without your explicit consent.
In accordance with the Health Insurance Portability and Accountability Act (HIPAA), all protected health information (PHI) you provide will be treated with strict confidentiality and protected against unauthorized use or disclosure. Guerrero Insurance Group LLC maintains appropriate administrative, physical, and technical safeguards to protect your information.
By clicking “Submit” (or checking the consent box below), you voluntarily consent to:
The collection and use of your personal and/or health information for insurance quoting purposes.
The sharing of your information with relevant insurance providers as necessary to obtain your quote.
The handling of your information in accordance with applicable federal and state privacy laws, including HIPAA.
You have the right to request access to, correction of, or deletion of your personal information at any time by contacting us at:
guerreroinsurancegroup@gmail.com
Guerrero Insurance Group LLC is committed to protecting your privacy. If you have any questions about our privacy practices, please contact us directly.
