Programs for Members

Part-time Practice
Risk Class Reduction
Retirement
Early Cessation of
Practice

Non-Private Practice
Status for Members Age
60 and Older

Disability
Higher Limits of Liability
Employee Coverage
Entity Coverage
Locum Tenens Coverage
Death
Termination of
Membership

Applications For Membership

Questions & Requests

 

Applications

The following applications may be viewed and printed. Once printed they can be filled out and either mailed directly to our office or faxed to us.

Mail: CAP-MPT
333 S. Hope St.
8th Floor
Los Angeles, CA. 90071
Fax: (213) 473-8776

Physician Application -- Adobe™ pdf document (Rev. 12/03)

Administrator/Manager Group Application

Entity Application

Employee Coverage Application (Rev. 04/04)

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