DUNN INSURANCE SERVICES LLC

NAIC Partnership Certified - Long-Term Care Specialists Since 1993

Contact Dunn Insurance Services LLC

Michael L. Dunn, CLTC
Mary Ellen Dunn, CLTC
4015 East Lupine Avenue
Phoenix, Arizona 85028
Office: 602-923-4949
Toll-free: 866-380-2169
Fax: 602-923-4950
info@dunninsuranceservices.org

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"; IF ($op != "ds") { // they need to see the form echo "$form_block"; } else if ($op == "ds") { if ($name == "") { $name_err = "Please enter your name!
"; $send = "no"; } if ($address == "") { $street_err = "Please enter your street!
"; $send = "no"; } if ($city == "") { $city_err = "Please enter your city!
"; $send = "no"; } if ($state == "") { $state_err = "Please enter your state!
"; $send = "no"; } if ($zip == "") { $zip_err = "Please enter your zip!
"; $send = "no"; } if ($hphone == "") { $phone_err = "Please enter your home phone #!
"; $send = "no"; } if ($ydob == "") { $date_err = "Please enter your date of birth!
"; $send = "no"; } if ($send != "no") { // it's ok to send! $to = "info@dunninsuranceservices.org"; $subject = "Request For Consultation"; $mailheaders = "From:Dunn Insurance Website \n"; $mailheaders .= "Reply-To: $email\n\n"; $msg = "The following person would like a consultation:\n"; $msg .= "Name:\t$name\n"; $msg .= "Address:\t$address\n"; $msg .= "\t\t$city, $state $zip\n"; $msg .= "Home Phone:\t$hphone\n"; $msg .= "Work Phone:\t$wphone\n"; $msg .= "Date of Birth:\t$ydob\n"; $msg .= "Spouse Date of Birth:\t$sdob\n"; mail($to, $subject, $msg, $mailheaders); echo "

Your Request for a consultation has been sent!

"; echo "

Use the navigation to return to the home page.

"; } else if ($send == "no") { echo "$name_err"; echo "$street_err"; echo "$city_err"; echo "$state_err"; echo "$zip_err"; echo "$phone_err"; echo "$date_err"; echo "$form_block"; } } ?>

Dunn Insurance Services LLC

602-923-4949 or, toll-free: 1-866-380-2169


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