Referral Form - REFER TO ASSURED PROTECT

Refer and earn with ASSURED PROTECT

Find out more about ASSURED PROTECT > www.assuredprotect.com

Assured Protect is to be presented as an extended part of the HD group. We have a 'Do, or Refer' philosophy at H D Consultants. With Consumer Duty in mind, we need to ensure that all of our Clients are provided with access to all relevant types of life insurance to meet their personal, family, mortgage and business insurance needs. Just arranging a mortgage and not arranging or referring the mortgage life cover is absolutely not sufficient under the CD rules.

When referring a Client to Assured Protect, they will contact our Client as though they are part of your team, and they can be referred to as the specialist insurance desk for H D Consultants,

To refer your Clients to Assured Protect for their protection needs, follow the steps below ............

Easy 1-2-3 Steps;

1) gain your Clients consent, and also obtain their agreed time for contact, for Assured Protect to call and progress their requirements

2) submit all details via the Referral form below - (Note - Assured Protect and also pipeline@ will simultaneously receive a copy of your form)

That's it!

All fields with an * must be completed before clicking the 'submit' button below.

Please leave blank:

SUBMISSION DETAILS

Your name (name of Broker):

Broker's telephone number:

Is this Client Introduced? (PLEASE SELECT):

No Yes

If 'Yes', please confirm the name of the Introducer. If 'No', please type NONE in this field:

CLIENT DETAILS

Personal Details

Title:

First Name:

Surname:

Contact Details

Email Address:

Phone Number 1:

Phone Number 2 (optional, but helpful):

PRODUCT DETAILS

Purpose of Enquiry:

PLEASE PROVIDE THE PREFERRED DATE AND TIME SLOT FOR YOUR CLIENT TO RECEIVE A CALL FROM ASSURED PROTECT

PREFERRED DATE AND TIME:

Useful documents (max 3mb file size):

Please confirm:

By ticking this box, you confirm the client has consented for their data to be passed to Assured Protect for the purpose of phoning them to provide an insurance advice and quotation service

NOTE - To save a copy of this NBSS for your own record before clicking the Submit button below, click "CTRL + P" and save this page as a PDF document.

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Your home may be repossessed if you do not keep up repayments on your mortgage.

We normally charge a Professional Client Fee for mortgage advice. The amount will depend on your circumstances. A typical fee would be £500. The actual Professional Fee may be more or less than this, and is subject to a full Fact Find discussion and research process. H D Consultants is a trading name of Howard Reuben who is an Appointed Representative of PRIMIS Mortgage Network, which is a trading name of Personal Touch Financial Services Ltd. Personal Touch Financial Services Ltd is authorised and regulated by the Financial Conduct Authority. This site is for UK Consumers only. Website Terms and Conditions click here for our Privacy Policy. GDPR Privacy Policy - click here (PDF download / view) This site contains third party links. By clicking these links you will depart from the H D Consultants' regulated site. H D Consultants nor PRIMIS Mortgage Network is responsible for the accuracy of the information contained within the linked site. The Financial Conduct Authority does not regulate some of the services listed. H D Consultants, mortgage and life insurance advisers, is authorised by the FCA no 403701. Our in house Wills and Trusts Practice is a long standing Member of the Society of Will Writers and Estate Planning Practitioners.

FP Ref: 1436009 / exp 25.08.2025

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