Medical Malpractice Forms from A. E. Barnes Insurance Agency

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781-335-1589

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Click on the links below to download the appropriate application PDF.

NOTE:

You will need to print, sign and email, mail or fax to:
A. E. Barnes Insurance Agency
141 Pleasant Street
South Weymouth, MA 02190
policies [at] aebarnes [dot] com
781-340-0628 (fax)

Physician's & Surgeon's Application
Partnership or Corporation Application
Emergency Physician Credit MACEPS Application
Certified Nurse Midwife Application
Dentist Professional Liability Application
Physician Limited Practice Application
Report A Claim
Coverys Commercial General Liability Application
Conditions For Anesthesia Credit
Botox / Cosmetic Procedures Addendum/Application
Healthcare Facility Application
Healthcare Facility Addendum
Claim Information Form

Insurance Coverage from A. E. Barnes Insurance is Provided by These Trusted Insurance Companies

141 Pleasant Street
South Weymouth, MA 02190