Quick Quote for Chiropractors

Please use this Quick Quote form to submit your current info to PRI, so that we may give you a fast estimate on coverage costs. Or, contact Marketing Department, at 800-632-6040, email: CONTACT-US@PRI.com

Fields with a * are required.

CONTACT INFORMATION

*
*
*
*
*
*
*
*

PROFESSIONAL LIABILITY INSURANCE HISTORY

* Surgery
No Surgery
Minor Surgery
2.
*
*
* Years of continuous coverage immediately preceeding this year.
Full Time
Part Time
Chiropractor
Nurse Anesthetist
Nurse Midwife
Nurse Practitioner
Physician's Assistant
Optometrist
Podiatrist
5. Expiration and Retroactive dates found on the cover page of your present policy
*
*
* $500,000 / $1,500,000
$1,000,000 / $3,000,000
Risk Management Program
No Consent Option
MagnaCare Member
Part-time
 
ALL QUOTES ARE ONLY AN ESTIMATE.
A PRI application will have to be filled out for an actual quote.