Information and Quote Request Form

Thank you for your interest in The Psychiatrists' Program. To receive an application, a personalized premium quotation and insurance assessment, and risk management resources please complete the following information. A PRMS representative will be in contact with you to provide further details.

You may also contact us directly at or (800) 245-3333.

*Required fields


About Your Current Policy

Please call (800) 245-3333 or e-mail for more information about The Program.

Renewal Application

If you have been asked to complete a renewal application - please click here.