American Professional Agency

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	1.0	Addiction Counseling
	1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12	Rates New Business Application (Except AR,WA) New Business Application (AR) New Business Application (WA) Policy N.Y. Policy MA Policy Surcharge Information Additional Insureds Request Increase Limits of Liability Extended Reporting Period Endorsement Refusal Form New Business Brochure

	2.0	Clergy & Pastoral Counseling
	2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13	Rates New Business Application (Except AR,WA) New Business Application (AR) New Business Application (WA) Policy N.Y. Policy MA Policy Surcharge Information Additional Insureds Request Increase Limits of Liability Questionnaire Extended Reporting Period Endorsement Refusal Form New Business Brochure

	3.0	Hypnotism
	3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15	Rates New Business Application (Except AR,WA) New Business Application (AR) New Business Application (WA) Policy N.Y. Policy MA Policy Group 5 Rate Qualification Surcharge Information Addendum Additional Insureds Request Increase Limits of Liability Extended Reporting Period Endorsement Refusal Form New Business Brochure BA Hypnotherapist Endorsement

	4.0	Marriage & Family Counseling
	4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15	Rates New Business Application (Except AR,WA) New Business Application (AR) New Business Application (WA) Policy N.Y. Policy MA Policy Surcharge Information Additional Insureds Request Increase Limits of Liability Increase Defense Reimbursement Extended Reporting Period Endorsement Form-FREE Extended Reporting Period Endorsement Form Extended Reporting Period Endorsement Refusal Form New Business Brochure

	5.0	Mental Health Counseling
	5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16	Rates New Business Application (Except AR,WA) New Business Application (AR) New Business Application (WA) Policy N.Y. Policy MA Policy Surcharge Information Additional Insureds Request Increase Limits of Liability Psy.Exclusion Increase Defense Reimbursement Extended Reporting Period Endorsement Form-FREE Extended Reporting Period Endorsement Form Extended Reporting Period Endorsement Refusal Form New Business Brochure

	6.0	Psychiatry
	6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20	Rates Surcharge Information Application Quarterly Billing Form Extended Reporting Period Endorsement Form-Disability,Retirement or Death Extended Reporting Period Endorsement Form New Jersey Consent Form Addendum to Application Claim Activity Form Darwin Risk Management for Psychiatrist's information Generic Policy Arizona Policy Pennsylvania Policy New York Policy New York Resident Application Increase Limits of Liability AACAP Brochure NY Consent Form Defense Reimbursement rate sheet/cover letter Defense Reimbursement Warranty Form

	7.0	Psychoanalyst
	7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16	Rates New Business Application (Except AR,WA) New Business Application (AR) New Business Application (WA) Policy N.Y. Policy MA Policy Surcharge Information Additional Insureds Request Increase Limits of Liability Psy.Exclusion Increase Defense Reimbursement Extended Reporting Period Endorsement Form-FREE Extended Reporting Period Endorsement Form Extended Reporting Period Endorsement Refusal Form New Business Brochure

	8.0	Psychology
	8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20	Darwin Rates Darwin New Business Application (Except AR,WA) Darwin New Business Application (AR) Darwin New Business Application (WA) Darwin Policy Darwin N.Y. Policy Darwin MA Policy New Business Brochure Surcharge Information Increase Limits of Liability Additional Insureds Request Part Time Discount Worksheet LA Form (Louisiana Patients Compensation Fund Membership) Adding a new employee Increase Defense Reimbursement Extended Reporting Period Endorsement Refusal Form DAR-Extended Reporting Period Endorsement Form-FREE DAR-Extended Reporting Period Endorsement Form Quarterly Billing Form Darwin Renewal Application

	9.0	School Psychologist
	9.1 9.2 9.3 9.4 9.5 9.6 9.7	Rates Surcharge Information Additional Insureds Request Part Time Discount Worksheet Increase Limits of Liability Extended Reporting Period Endorsement Refusal Form New Business Brochure

	10.0	Schools
	10.1 10.2 10.3 10.4 10.5	Rates Application Application Renewal Surcharge Information Policy

	11.0	Social Service Agency
	11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11	Rates Application Additional Insureds Request Increase Limits of Liability Guidelines Policy Surcharge Information Renewal Application Renewal Application Addendum Application Addendum Gen-165(MN) Minnesota Insurance Guaranty

	12.0	Social Workers
	12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18	Rates NY NASW Professional Liability Application NASW Professional Liability Application NASW Professional Liability Renewal Application NEW NASW Professional Liability Renewal Application (10/2008) Surcharge Information Increase Limits of Liability Additional Insureds Request Gen-165 (MN) Minnesota Insurance Guaranty Association Law SWL-123 Disclosure Form Purchasing Group Membership Letter Psychology exclusion endorsement Defense Warranty Policy Contract NASW Professional Liability Application (NM) Part-time Worksheet Extended Reporting Period Endorsement Form (No Charge) Extended Reporting Period Endorsement Form (Purchase)

	13.0	Student
	13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10	Rates Surcharge Information Increase Limits of Liability Gen-165(MN) Minnesota Insurance Guaranty Association Law NASW Professional Liability Application General Professional Liability Application NASW Professional Liability Application (NM) General Professional Liability Application Renewal Policy New Business on-line application

	14.0	Physical Therapists (Allied)
	14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8	Application Policy Find Rate Premium Rate Schedule Premium Rate Schedule-California Surcharge Information Massachusetts Residents Application New Jersey Resident Application

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Last updated on 06/18/2010