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[  On click · Centred modal  ]

Three-step insurance quote from a Get a quote button

An insurance broker's quote form opened by any Get a quote button: coverage and ZIP, then renewal timing, then contact details with consent. Easy questions first, personal details last.

Generate leadsFinance & insuranceLocal services
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promptGive this to your agent

“We're an independent insurance broker. Every 'Get a quote' button on coverwise-insurance.com (they all have the class get-quote) should open a quote form that feels quick: first what cover they need and their ZIP code, then when their current policy renews, and only at the end their name, email and phone, with a consent checkbox so we can call and email them about quotes.”

How it behaves

Layout
Centred modal
Opens
When the visitor clicks an element matching .get-quote.
Where
Every page
Devices
Every device
Shows
Every time it is triggered.
Size
Medium
Page behind it
Dimmed; a click outside closes it
Close button
Yes
Steps
3, with a progress bar
After submit
A short confirmation, then it closes

What it asks · 7

Step 1

  • Coverage neededrequiredSingle choice

    Auto · Home · Auto and home bundle · Renters · Small business

  • ZIP coderequiredShort text

Step 2

  • Renewal timingrequiredSingle choice

    Within 30 days · In 1 to 3 months · More than 3 months away · I don't have a policy yet

Step 3

  • Full namerequiredShort text
  • EmailrequiredEmail
  • Phone numberrequiredPhone
  • Consent to contactrequiredMultiple choice

    Coverwise may call, text and email me about my quote.

Answers are saved under each question's label, which is also the column in your CSV export.

Make it yours

  1. 01

    Connect your agent

    Claude Code, Cursor or any MCP client, with or without an account.

  2. 02

    Paste the prompt, in your words

    Change the business, the offer and the timing. The agent starts from this template and edits it.

  3. 03

    Publish and paste one script

    One tag per site serves every popup you publish on it.

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