Professional Liability Application

Use our application:
To apply for coverage, please click on the PDF application below and fill it out on line. You can save your partially completed application to your computer to complete at a later time. Then print it and either fax it to us at 970-225-6596 or email it to us at  You can also click on "Tools" in the PDF document and email it directly.

Professional Liability Application PDF

You can also mail it to:
Front Range Insurance Group, LLC
P.O. Box 270550
Fort Collins, CO 80527

Use your application:
You can email or fax your application to or Fax it to 970-225-6596.

It can also be mailed to the address above. Only one application is needed for us to quote multiple carriers. There will be on occasion a company specific application required to bind coverage. Once we receive your application, one of our team members will contact you.