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Individual Professional Liability Insurance Occurrence Application For members of the United States Trader Association Mail To: 159 East County Line Road, Harbor, PA 19040-1218 Toll-Free #: 1-888-273-4610
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It is a PDF application form for the Health Professionals Service Organization (HPSO) in the United States.
Healthcare professionals who wish to obtain malpractice insurance through HPSO are required to file this application.
The application must be filled out completely, accurately, and submitted with all required documentation.
The purpose of the application is to collect information about the healthcare professional applying for malpractice insurance.
Information such as personal details, licensure, experience, prior claims history, and coverage preferences must be reported on the application.
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