Contact Us If you have any questions or comments about our services please feel free to e-mail us at: marty@martypuinltc.com  Our address is: Marty Puin & Associates Inc. 5001 Mayfield Rd. Suite #126 Lyndhurst, OH 44124 (216) 381-8039 (Office) (216) 381-8059 (Fax)  For a quote request please provide the following information:   Name:   Date of Birth:   City:   State:   Zip Code:   Phone #:   Best Time to Call:   e-mail Address:   Height:   Weight:   Smoker:  Yes  No   Has Applicant Ever Had Cancer:  Yes  No   Stroke:  Yes  No   Diabetes:  Yes  No   Date of Diagnosis:   Provide Details:   SPOUSES NAME:   Date of Birth:   Height:   Weight:   Smoker:  Yes  No   Has Applicant Ever Had Cancer:  Yes  No   Stroke:  Yes  No   Diabetes:  Yes  No   Date of Diagnosis:   Provide Details: After filling the details click on the SUBMIT button.

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