Contact & Requests

Tell Us What You Need.
We Will Take It From There.

Choose what you are interested in below and complete the matching form. Patrick will personally reach out within 24 hours. Your information is private and never sold.

Your Request Is In!

Thank you. Patrick will personally reach out within 24 hours to confirm the next step. Keep an eye on your email.

Book Your Free Strategy Session

30 minutes. Virtual. 100% free with zero obligation.

First Name *

Last Name *

Email Address *

Phone Number

What would you like to talk about? *

Anything else Patrick should know?

By checking this box, I agree to receive marketing text messages from Patrick Frick / Emberstone Capital, LLC at the phone number provided. Messages may include insurance product information, appointment scheduling, and financial strategy updates. Message frequency varies. Message & data rates may apply. Reply STOP to unsubscribe. Reply HELP for assistance.

By checking this box, I agree to receive non-marketing text messages from Patrick Frick / Emberstone Capital, LLC regarding appointment confirmations, reminders, and service updates. Message & data rates may apply. Reply STOP to unsubscribe. Reply HELP for assistance.

Consent to receive text messages is optional and is not a condition of any purchase or service. No mobile information will be shared with third parties or affiliates for marketing or promotional purposes. See our Privacy Policy and Terms of Service.

Your info is private & secure. Patrick will confirm within 24 hours.

Free Mortgage Protection Review

Real quotes from multiple carriers, matched to your home and your situation.

First Name *

Last Name *

Email Address *

Phone Number *

State *

Approximate Mortgage Balance *

Age Range *

Do you currently have life insurance? *

Primary Concern *

Additional Information

100% free review. Zero obligation.

Free IUL Analysis

A custom illustration built around your numbers and your goals.

First Name *

Last Name *

Email Address *

Phone Number *

Age Range *

Annual Income Range *

Primary Goal *

Anything else Patrick should know?

Free custom illustration. Zero obligation.

Free Annuity Review

Real projections based on your savings, not hypotheticals.

First Name *

Last Name *

Email Address *

Phone Number *

Age Range *

Approximate Savings Available *

Primary Goal *

Additional Notes

100% free review. Zero obligation.

Join the Team: Pre-Application

Step 1 of 4. Takes about five minutes. Your Social Security Number is not collected on this form.

Please read the Important Disclosures before applying. Applications cannot be accepted from residents of Guam, Maine, Minnesota, Puerto Rico, or the U.S. Virgin Islands.

Section A: Basic Information

First Name *

Middle Name

Last Name *

Suffix

Email Address *

Retype Email Address *

Section B: Background Information

Street Address *

City *

State *

Zip Code *

Phone Number *

National Producer Number (optional)

Recruiter / Agent Code (if you were referred)

Section C: Background Questionnaire

Answer honestly. A "Yes" answer does not automatically disqualify you.

1. Have you ever been terminated or denied appointment by Biz To Biz Insurance Solutions? *

Yes

2. Have you ever been convicted of a crime involving insurance, fraud, theft, or financial wrongdoing? *

Yes

3. Have you filed for bankruptcy within the last 10 years? *

Yes

4. Have you ever had a complaint filed against you with a state insurance department, or had a license suspended or revoked? *

Yes

5. Do you have any outstanding debit balances with an insurance company or unsatisfied judgments? *

Yes

6. Have you ever been found liable in a civil action involving fraud or breach of fiduciary duty? *

Yes

7. Have you ever had a contract with an insurance entity involuntarily terminated? *

Yes

8. Are you currently employed by an insurance carrier or financial institution? *

Yes

9. Are you the subject of any ongoing complaint or investigation? *

Yes

Section D: Certification

By typing your full name and today's date below, you certify that all information provided is accurate and complete, and you authorize Emberstone Capital, LLC to transmit this information to Biz To Biz Insurance Solutions LLC for review.

Type Your Full Legal Name *

Today's Date *

Section E: Text Message Consent (Optional)

Consent to receive text messages is optional and is not a condition of any purchase, service, or application. No mobile information will be shared with third parties or affiliates for marketing or promotional purposes. See our Privacy Policy and Terms of Service.

Patrick reviews every submission personally and responds within one business day.

Send a Message

Question, comment, or something that does not fit the other forms? Send it here.

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Email Address *

Your Message *

Your info is private & secure.

Tell Us What You Need.We Will Take It From There.

Your Request Is In!

Book Your Free Strategy Session

Free Mortgage Protection Review

Free IUL Analysis

Free Annuity Review

Join the Team: Pre-Application

Send a Message

Tell Us What You Need.
We Will Take It From There.