Client Intake | Miguel Cintora

Client intake

Share sensitive details
without saying them
over the phone.

Choose your carrier, then enter only the personal and banking details needed for your application.

Enter your information privately, at your own pace.
Review your details before sending. Submitted information is stored encrypted. Miguel receives an email with a private link, without your sensitive details in the email.

Who is this for?

Enter your name so Miguel knows whose information he is receiving.

Full Legal Name

Choose your insurance carrier

Tap the company your policy is going through. Your completed intake will be clearly labeled for that carrier.

Personal Information

Enter the details exactly as they appear on your identification.

♢ Your information is sent only after you review it and select Send to Miguel.

Date of BirthType 8 numbers — the slashes appear automatically.Social Security Number

Driver’s License Number

Financial Information

Enter the account details requested for your application.

Bank Name

Account TypeCheckingSavings

Routing NumberAccount Number

Ready when you are.

Review your carrier-labeled details before sending them to Miguel.