top of page

Welcome! Let's get you started with an application.

Icon apply.png

Please return completed application with the following items: 

  • Most updated CV 

  • Active medical License 

  • Copy of complete current policy, if we are being asked to replace a current policy

  • Conservative Estimate of first year Patient Panel Size and anticipated maximum patient panel size

  • Loss runs report from current carrier orNPDB REPORT.   NPDB report A National Practitioners Database query can be made at the following link here Self-Query Home - hrsa.gov, npdb self query

Eventually, after securing coverage we will requireClaims History for the last 10 years, or for as long as you have been in practice, whichever is shorter.

Once you've completed your application:

Email the completed application to: quote@mydpcinsurance.com

We strive to give you the best policy.

We strive for excellence for our clients, and understand DPC practice model thoroughly. No other carriers outside of this program are quoting according to your reduced exposure. 

Coverage highlights:

  • Free Retirement Tail

  • Quarter Time and Part Time discounts

  • Full Consent to Settle on Claims

  • Defense costs outside of the Limits of Liability

  • No premium penalty for early termination of coverage

Contact us

For any inquiries please email Citlally Mancilla: contact@mydpcinsurance.com or at 210.689-6673

bottom of page