Physicians Insurance, A Mutual Company
The premier provider of medical professional liability insurance
for physicians and clinics in Washington, Oregon, and Idaho.

Member Login
Highlights
Policy Requests
For each of the following applications, forms, and questionnaires, please complete the information, sign, and send it to us. Send by fax to (206) 343-7100, by e-mail to marketing@phyins.com, or by mail to Physicians Insurance, 1730 Minor Avenue, Suite 1800, Seattle, WA 98101. Please note that we require a signature for processing.

Professional Liability Insurance Applications
Applications and Forms
Specialty Questionnaires


Professional Liability Insurance Applications
For personal assistance with either of the following professional liability insurance applications, please contact our Marketing Department at (206) 343-7300 or 1-800-962-1399.

Corporation/Partnership Professional Liability Insurance Application (available for practices with two or more physicians)
Physicians and Surgeons Professional Liability Insurance Application
 

Applications and Forms
For personal assistance with any of the following applications and forms, please contact our Underwriting Department at (206) 343-7300 or 1-800-962-1399.

Ambulatory Surgical Facilities Underwriting Information Form
Increase Limits of Liability Application
Locum Tenens Application
Midlevel Provider Application
Midlevel Providers Providing Care to Obstetrical Patients Application
Moonlighting Residents & Fellows Application
Per-Diem Physician Application
Practice Change Application
Suspension Request Form


Specialty Questionnaires
For personal assistance with any of the following specialty questionnaires, please contact our Underwriting Department at (206) 343-7300 or 1-800-962-1399.

Acupuncture Questionnaire

Bariatric Surgery Questionnaire
Body Imaging Questionnaire
Nighthawk Questionnaire
Pain Management Questionnaire
Practice Association Questionnaire
Refractive Surgery Questionnaire
Sleep Medicine Questionnaire
Teleradiology Questionnaire

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