Application Information

Summary

The applications within will assist us in collecting the information necessary for providing an accurate, competitive quote. Separate applications have been created for each line of coverage so that we can meet your specific and immediate insurance needs. Please complete select the applications based on the coverage that you are seeking per the explanation below.

Which Applications Do I Need to Complete?

Non-Professional Application – Required for all property, general liability, equipment and workers compensation quotes. Please complete to the best of your ability and submit. If additional information is needed, we will follow up with you directly

Professional Liability Application – Laser Spa – Required for professional liability quotes for all laser spa facilities. The items listed below may be required and will help to expedite the quoting process:

  • Resumes or CV’s for principals and partners
  • Brochures, marketing materials, or advertising materials
  • Five years of currently valued company loss runs
  • Information on disciplinary action, license revocations, etc
  • Copy of most current declaration page(Current policy sheet that lists coverage limits,etc)
  • Copies of documents verifying training or certification

Professional Liability Application – Medical Director – Required for professional liability quotes that would like to include coverage for the Medical Directors. The items listed below may be required and will help to expedite the quoting process:

  • Resumes or CV’s for principals and partners
  • Five years of currently valued company loss runs
  • Proof of medical malpractice coverage for Medical Director
  • Copy of the contract between Medical Director and the facility


Non-Professional Application
Professional Liability Application - Laser Spa
Professional Liability Application - Medical Director



For more information please contact:
Chad Suter
csuter@laprescali.com
480-947-3556

Model