Please provide answers to the questions below.

Question Title

* 1. Legal Business Name  
Including DBA names

Question Title

* 2. What is your practice's legal structure? 

Question Title

* 3. How is the practice classified by animal type?
The Trust classifies wildlife, zoo, and fur-bearing animals as small animal. Cervidae, poultry, and ratites are classified as food animals

Question Title

* 4. Your name, company, practice address, email and phone number

Question Title

* 5. How many years has the practice been in business?

Question Title

* 6. How many locations does your practice have? 

Question Title

* 7. How many employees do you have? 

Question Title

* 8. Total Current Number of Employees with compensation (including bonuses):

Question Title

* 9. Within the last 3 years, has the Applicant been the subject of or involved in any claim, written demand, notice, proceeding, litigation or investigation alleging a discriminatory practice, unlawful harassment or any other employment or labor related violations?

Question Title

* 10. How many employees, including veterinarians, have been involuntarily terminated in the past 12 months?

Question Title

* 11. None of the individuals to be insured under this coverage is responsible for or has knowledge of any wrongful act or fact, circumstance or situation which they have reason to believe might result in a future claim, except as follows (if None, so state):

Question Title

* 12. Have you distributed to employees written policies, guidelines or procedures addressing human resources issues?

Question Title

* 13. Are you interested in any of these other AAHA Business Insurance Program coverages? 

( Privacy & Cookie Notice

T