ProAssurance


2019 DE Physician Seminars

ProAssurance Mail-In Form

To register, print this form and complete the information below. 

Amount: $100.00
Payable To: ProAssurance Indemnity

You can mail the completed form and your check to:

ProAssurance Companies
Risk Resource Services
PO BOX 809196
Chicago, IL 60680-9196


Seminar Details

Out of Bounds: Previous Claims Under Further Review

Seminar Date: 08/08/2019
Location: Chase Center on the Riverfront
Price: $100.00
Seminar: 6:00 PM - 8:00 PM. Sign-in begins at 5:30 PM.

Your registration fee is not refundable, yet is transferable to another one of our 2019 Physician seminars.

ProAssurance will send you a registration confirmation and directions two weeks prior to the seminar.


Registrant Information (please print)

Physician or Provider’s Name:
(First)                          (Last)                           (Degree)
Group Name:
Street Address:
City, State, Zip:
Phone:
 Email:
If your group is not insured with ProAssurance Group, what is the expiration date of your current policy?

Questions?

Call 844.223.9648 and choose option 2.