Application for Medical and Professional Liability Insurance

Instruction for returning Applications

  1.  Click on the Application you want to download.

  2.  Open your downloaded Application.

  3.  Fill out the Application

  4.  Save Application using your last name in the file name if possible.


3 ways to send


1.  Attach Application File to an email address to


2.  Fax Application to (586)585-1352


3.  Print out Application and mail to :


Interstate Healthcare

24150 Little Mack Ave.

St. Clair Shores, MI 48080




Application List