Life & Critical Illness Insurance

Medical Information Questionnaire
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Step 1

Lifestyle and health habits

Short screening questions first. Details appear only where your answer makes them relevant.

Smoking, vaping and nicotine

Have you used any tobacco or nicotine product during the last 12 months? This includes cigarettes, cigars, pipes, shisha, vaping or e-cigarettes, heated tobacco, nicotine pouches, chewing tobacco and nicotine replacement products.

Have you previously used tobacco or nicotine but stopped more than 12 months ago?

Alcohol

Do you currently drink alcohol?

Has a health professional ever advised you to reduce or stop drinking alcohol?

Have you ever received counselling, treatment or support for alcohol use, or attended a support service or group?

Recreational drugs and non-prescribed substances

During the last 10 years, have you used cannabis, cocaine, ecstasy, amphetamines, opioids, psychoactive substances, anabolic steroids, performance-enhancing drugs or any other recreational or non-prescribed drug?

Have you ever misused or become dependent on prescribed or non-prescribed medication, or received treatment or support for drug use?

Anything else relevant at this stage?