Insurance Quote for Eye Care Professionals

Insurance Quote for Eye Care Professionals

For a quick and easy quote please follow the directions below or call 1-888-297-5230.

Fields with a * are required.

Please select all that apply from the list below, for the type of quote you would like to receive.*:
Coverage options may not be available in all states. You may select more than one.

 Professional Liability General Liability Employment Practices Liability Property Coverage Workers’ Compensation Umbrella Coverage Cyber Liability Coverage Disability Insurance Business Overhead Builders Risk ERISA Bonds

Please select a category for the type of quote you would like to receive.*

Type of Entity*

Association with Practice*

Name of Legal Entity:*

Provider Information


First Name:*

Last Name:*

Practice Address:*

City:*

State:*

Zip Code:*

County:*

How would you like to be contacted:*

Phone:*

Fax:

Email Address:*

Contact person different from listed above?

If YES, plese provide contact information below:

First Name:

Last Name:

Phone:

Fax:

Email Address:

Practice Information


Practice Name:

Do you perform surgery?

Current Carrier:

Policy Type:

Current Liability Limits:

Current Premium:

Effective Date:

Retroactive / Prior Dates:

Comments: