For current policyholders ONLY:  These forms are intended to amend an existing policy.  If you will not be making these changes until it is time for you to renew your policy, you may make the changes on your renewal application.  If you are a new applicant, click here for applications.  All requests are processed within 5-7 business days, and all revised documents are sent via the method of your choice.  For faster service, please request delivery by e-mail or fax. 

1. Change of Name and/or Address
For customers (all categories) who have moved or changed their name since taking out their current policy.
[ Download WORD.doc ]   [ Download Acrobat.pdf ]

2. Adding Additional Insured
For customers (all categories) who need to add their landlord, employer, professional corporation, or other as an “Additional Insured” on their existing policy.
[ Download WORD.doc ]   [ Download Acrobat.pdf ]

3. Upgrade in Category and/or Limits
For licensed/certified professionals (categories A, B, or C) who would like to change their existing limits of liability and/or who have changed the number of self-employed hours they are working per week.
[ Download WORD.doc ]   [ Download Acrobat.pdf ]

4. Status Change:   Student/Trainee to Intern/Post-Master’s
For students/trainees (category D) who have recently graduated from a Master’s program and who will be working under supervision toward licensure or certification.
[ Download WORD.doc ]   [ Download Acrobat.pdf ]

5. Status Change:   Intern/Post-Master’s to Licensed/Cert. Professional
For Interns/Post-Master’s policy-holders (category E) who have completed their term of working under supervision and who have become a licensed or certified professional (category A, B, or C).
[ Download WORD.doc ]   [ Download Acrobat.pdf ]

6.  GROUP/CORP’s ONLY:  Adding New Employee
For Corporations or Groups who wish to add a new employee to an existing policy.
[ Download WORD.doc ]   [ Download Acrobat.pdf ]

7. Student Blanket ONLY: Add new students
For Student Blanket Group policies ONLY who wish to add a new list of students to the policy.
[ Download WORD.doc ]   [ Download Acrobat.pdf ]

8. Request for Upgrade from Individual to Group and/or Corporate Coverage
[ Download WORD.doc ]    [ Download Acrobat.pdf ]

9. Other:  General Corrections
For customers (all categories) who would like to make changes to their occupation, the appearance of their declarations page or other documents, or who would like to make a change not described in any of the above forms.
[ Download WORD.doc ]   [ Download Acrobat.pdf ]

10. CPH TOP Application (General Liability & Property Insurance)
[ Download WORD.doc ]    [ Download Acrobat.pdf ]