PROFESSIONAL LIABILITY INSURANCE EXPRESS APPLICATION
For Healthcare Professionals (Allied Personnel)
Agent name: Mike Grady
Address 1: 1850 Forest Hill Blvd, Suite #101
City: West Palm Beach State: FL Zip: 33406 Phone: 561-540-8017 Fax: 561-540-8650 E-mail: mgrady@gradyprofessional.com
Website: www.gradyprofessional.com
Application Instructions and Checklist
Prior to completing the attached application, please read and observe the following instructions. Please verify that all required attachments are included in order to assist us in processing your application promptly and efficiently.
Required Attachments
Please include a current copy of the following documents with the application:
COVERAGE SELECTION
Please indicate coverage type desired:
CORPORATE OFFICE:
1850 Forest Hill Blvd, Suite 101
West Palm Beach, FL 33406
(866) 80-GRADY (804-7239)
FAX: (866) 874-7239
WEST PALM BEACH OFFICE:
PO Box 15047
West Palm Beach, FL 33416-9915
(866) 80-GRADY (804-7239)
FAX: (866) 874-7239
ORLANDO OFFICE:
PO Box 533064
Orlando, FL 32853
(888) 87-GRADY (874-7239)
FAX: (888) 834-7239
Privacy Policy: Collection and Use of Contact Information: We respect your privacy. Any phone numbers and email addresses collected by Grady Professional Services, Inc. are used solely for the purposes specified at the time of collection, such as providing updates, information, or alerts relevant to your relationship with us. We do not sell, rent, or share your contact information with third parties, except as required by law or to fulfill our service obligations to you. You have the right to opt out and request removal of your contact information from our lists at any time. Upon receiving your request, we will promptly remove your information from our records, except as required to comply with applicable laws. To do so, contact us: Call us at: (561) 540-8017 Email us at: info@gradyprofessional.com Write us at: PO Box 15047, West Palm Beach, FL 33416 or Text us at: 561-540-8017.
Legal Notice: By providing your phone number and/or email address, you consent to receive communications from Grady Professional Services, Inc. We comply with all applicable laws, including but not limited to the Telephone Consumer Protection Act (TCPA), the CAN-SPAM Act, and any relevant state privacy laws. You may withdraw your consent or exercise your rights at any time using the methods listed above. If you have any questions about our privacy practices, please contact us using the information provided.
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