Malpractice Quick Quote SMS

Please take a moment and complete this form. On average, you can expect to save 10% to 40% off of what you are currently paying for your malpractice insurance, depending on the state you are practicing in. More importantly, because we offer 7 different types of policies you can be assured you are not only getting the best price but also the right policy for your practice.

Once received, one of our Representatives will contact you within 24-48 hours. We appreciate the opportunity to serve you.

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Your Limits of Liability?


Is your policy an...



Referred by?



Current Carrier?

Please check any of the following if you perform..
Ultrasound
Urinalysis¨C Done by Dr
Perform Needle EMG/ MRI/ CT Scan/ EKG
Diathermy
Hours per week spent with patients (including treatments, note charting & consulting)

How many patient visits do you see per week?

Attach Current Declarations Page (2MB Max)


Claims History


Board Complaint