Bee Insurance | Your best choice

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RISK DECLARATION

Click if your answer is yes for each question and provide details as appropriate.

Have you ever suffered from cardiovascular diseases: arterial hypertension, myocardial infarction, cardiac arrhythmia, angina pectoris, rheumatic fever, arteriosclerosis, valvular disorders, thrombophlebitis? If yes, give details: Date of diagnosis, Treating physician, Current health status.

Have you suffered from Endocrine diseases: diabetes, obesity, cholesterol and triglyceride disorders? If yes, please provide details: Date of Diagnosis, Treating Physician, current health status.

Have you ever suffered from Hematological diseases? If yes, please provide details: Diagnosis, Date of onset, Treating Physician, current health status.

Do you use: Tobacco or cigarette or any other addictive drug? If yes, please provide details: Date of onset of habit, Daily amount, Current health status?

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