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Welcome to the Western Financial Group FAST Path Form

FAST Path Form

It’s easy. It’s only one page and takes one minute. One of our insurance brokers will contact you in 15 minutes.

It’s easy. It’s only one page and takes one minute. One of our insurance brokers will contact you shortly.

Step 1: Please pick a product:

Step 2: Select one of the options:

Need an insurance quote
Service Request
Talk to an insurance expert

Step 3: Tell me more about your insurance needs:

Tell us about your business:

Company Name
How Many Employees?
If you have an existing policy feel free to attach it here:

Step 4: Fill in your contact information:

First Name
Last Name
City/Town
Province
Postal Code
Phone Number
Email
Preferred Method of Contact
Attach a file
Please indicate your consent
By selecting this checkbox, I/we agree to all the terms and conditions required for the purpose of requesting a quote.