Home Page
Members Only Area
- Why sign up?
Headline News
Membership Services
Risk Management
& Patient Safety
Claims Services
Other Services
for Physicians
Our Law Firm
About Us
- Our dedication to
Physicians
Contact Us
Tell us what you think
Lower Your Risk
Lower Your Assessments
Service Your Claim
Build Your Practice
Programs for Members
Applications for Membership
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:
Cooperative of American Physicians, Inc.
333 S. Hope St.
8th Floor
Los Angeles, CA. 90071
Fax:
213-473-8776
Physician Application (Rev. 04/05)
Entity Application (Rev.10/06)
Employee Coverage Application (Rev. 06/06)
Member Services Index
Part-time Practice
Risk Class Reduction
Retirement
Early Cessation of Practice
Non-Private Practice
Status for Members 58 +
Disability
Higher Limits of Liability
Employee Coverage
Entity Coverage
ORP Application
Locum Tenens Coverage
Death
Termination of Membership
Applications for Membership
Questions & Requests
All contents of this website © 1999-2007 Cooperative of American Physicians, Inc.
