Call: 01792 001350

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Offices & Surgeries Insurance – Quote Request

Please complete as much as possible so we can obtain tailored office or surgery insurance terms.

Your details

Business name *

Registered name

Correspondence address *

Postcode *

Telephone *

Email *

Business details

Business type *

Year established

Description of activities *

Number of directors / partners

Number of employees *

Annual turnover £ *

Premises & construction

Risk address

Year built

Construction

Listed building?

Number of storeys

Flood / subsidence history?

Clinical / treatment exposure (if applicable)

Any treatments performed?

If yes, details

Use of lasers or invasive procedures?

Professional indemnity required?

Property sums insured

Buildings sum insured £

Contents / furniture & equipment £

Medical equipment £

Computers & electronics £

Liability

Employers liability required?

Public liability limit

Claims & history

Claims in last 5 years? *

Claims details

Current insurance

Current insurer

Renewal date

Anything else

Additional information

By submitting this form you consent to Miller & Partner Ltd contacting you regarding this quotation.

Office: Vivian House, Roman Bridge Close, Mumbles, Swansea, SA3 5BG

Call 01792 001350

Email: [email protected]

Miller & Partner is an Authorised Representative of Gauntlet Risk Management Ltd and are authorised and regulated by the Financial Conduct Authority (FCA) under firm reference number 1029698. You may check this on the Financial Services Register by visiting the FCA website, https://www.fca.org.uk/register/ or by contacting the FCA on 0800 111 6768 Privacy Policy