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Please use the space below to provide any additional information you feel would help us in evaluating your application It is a crime to knowingly provide false incomplete or misleading information to an insurance company for the purpose of defrauding the company. Banner Life Insurance Company 3275 Bennett Creek Avenue Frederick Maryland 21704 800 638-8428 Alcohol/Drug Usage Questionnaire Supplement to Application Do you presently use alcoholic beverages Yes No If Yes please advise Frequency...
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What is alcoholdrug usage questionnaire?
The alcohol/drug usage questionnaire is a form used to gather information about an individual's alcohol and drug usage habits.
Who is required to file alcoholdrug usage questionnaire?
Employees or individuals who are mandated by their organization or jurisdiction to complete the form are required to file the alcohol/drug usage questionnaire.
How to fill out alcoholdrug usage questionnaire?
The alcohol/drug usage questionnaire can typically be filled out by answering a series of questions related to alcohol and drug consumption habits.
What is the purpose of alcoholdrug usage questionnaire?
The purpose of the alcohol/drug usage questionnaire is to gather information about an individual's alcohol and drug usage behaviors for various reasons such as monitoring compliance with policies or assessing potential risks.
What information must be reported on alcoholdrug usage questionnaire?
The information reported on the alcohol/drug usage questionnaire may include details about frequency of alcohol/drug consumption, types of substances used, and any related issues or concerns.
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