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After Insolvency CCJ & Adverse Credit Pubs & Restaurants Airbnb & Short Let Aesthetics & Beauty Golf Clubs Personal Trainers Esports & Gaming Dog Grooming Alternative Therapies

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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.

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Proposer first name *

Proposer last name *

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 £

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

Call 01792 001350

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Miller & Partner Ltd is an Appointed Representative of Gauntlet Risk Management Ltd, which is authorised and regulated by the Financial Conduct Authority (FRN 308081). Miller & Partner Ltd is entered on the Financial Services Register under firm reference number 1029698. You may check this on the Financial Services Register by visiting the FCA website at https://www.fca.org.uk/firms/financial-services-register or by contacting the FCA on 0800 111 6768. Miller & Partner Ltd is registered in England & Wales, company number 16206282. Registered office: 20 Vivian House, Roman Bridge Close, Swansea, SA3 5BG.