Simply put in your Zip Code, Limits of Liability and Date of Licensure and instantly see how much money you can save on your malpractice insurance with ChiroSecure.
  • Use the dropdown to select a specific incident/annual aggregate.

I am not currently insured with ChiroSecure, and I would like to receive the ChiroSecure Concierge Service, PLUS, I would like to know if ChiroSecure can save me money on my Malpractice Insurance Premium. I understand that by completing this form, I may save between 10 - 40% off my current policy premium and get a policy that is better for my business than the one I currently have.


Your Limits of Liability?

Is your policy an...

Referred by?

Current Carrier?

Please check any of the following if you perform..
Urinalysis¨C Done by Dr
Perform Needle EMG/ MRI/ CT Scan/ EKG
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