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Certificate of Insurance Request

Current Clients

If you’re already a client, the fastest way to request a certificate is directly through the Insurance by Dentists app. Use the form below as a backup — we’ll follow up if we need anything else.

Request a Certificate

Upload certificate requirements or drag & drop

Optional — PDF, Word, or image · up to 10 MB

Insurance coverage and/or claims cannot be bound, amended, or canceled through this form. An Insurance by Dentists team member will follow up to assist you.

Please fill in all required fields and check the acknowledgement box.
Request received. We’ll be in touch shortly.