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Naturopath Medical Professional Liability Questionnaire

All Questionnaires submitted through this website are subject to carrier and underwriting review. By submitting a questionnaire through this website, there is no guarantee or warranty of coverage. Additional information may be required in order to provide a quote.

Name *

Mailing Address (Street, City, Zip) *

Corporation Name or Employer Name

Practice Address (Street, City, Zip)

Phone *

Email *

Your Practice Website

Please select one or more Groups that best describe the procedures you perform in your practice (see the list to the left) *

Group A

Group B

Group C

Do you work less than 20 hours per week? *

Yes

No

Licensed / Authorized as

NMD

ND

Other

Provider Status

Practice Owner

Employee

Independent Contractor

How many years have you been practicing?

Do you administer or assist in the administration of General Anesthesia or IV Sedatives?

Yes

No

Requested Effective Date *

Requested Retroactive Date (based off of your current policy to provide the most accurate quote)

Requested Policy Limits *

$200,000 / $600,000

$1,000,000 / $3,000,000

Enter the State or States that you are requesting coverage *

Leave this field blank

Thank you for submitting an application. One of our service professionals will be in contact with you ASAP.

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Insurance Quote for Naturopath Liability Insurance

Insurance Quote for Naturopath Professional Liability Insurance

Naturopath Liability Insurance Quote

Naturopath Professional Liability Insurance Quote

Group A

- Acupuncture / Oriental Medicine
- Duties as a Medical Director
- Homeopathy
- Holistic Medicine
- Nutritional Therapy
- Ozone Therapy
- Ultra Violet Light Therapy

Group B

- Botox Injections
- Lasers (Aesthetic)
- Mesotherapy
- Minor Office Surgery
- Prolo (Sclero) Therapy
- Trigger Point Injections
- Use of local anesthetic in minor office surgery
- Oral EDTA Chelation Therapy
- Medical Marijuana
- Exercise with Oxygen Therapy
- Bio-Identical Hormone Replacement
- Infrared Laser Therapy

Group C

- IV EDTA Chelation Therapy
- Maternal Pre-Natal & Post-Natal Care
- Fillers
- HCG Weight Loss Injections
- IV Nutrient Therapy

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Desert Mountain Insurance Services Inc.

Desert Mountain Insurance Services / DMIS-US specializes in providing insurance services to professionals and businesses. We conduct business nationwide with offices in Arizona, California, Nevada and Delaware. It is our goal to provide each client with the highest standard of customer service.

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Wilmington, DE 19807

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