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VETERINARY PROFESSIONAL INSURANCE
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To confirm your eligibility for VPIS Liability Insurance, please complete the form below with the name of the Practice and
contact information of the person responsible for this application.

I am applying as a Sole Practitioner

Yes No

If your selection doesn't describe your business activity, please go back to Apply for VPIS Insurance and choose the activity that best describes your business situation.

If unsure, please contact Crombie Lockwood Insurance Brokers on 03 339 5291.

First Name

Last Name

If you have an nzbn.govt.nz registered business name for your veterinary activities, please enter here.

Yes No

Registered Practice Name

Does your business have a trading name?

Yes No

Trading Name

Practice Phone Number

Practice Email Address

Forgotten your password?
Please use the forgotten password link after you select Manage my Insurance at www.vpis.org.nz. Otherwise contact the VPIS Broker, Crombie Lockwood on 03 339 5294 (between 8.30am-5.00pm Mon-Fri) to confirm your login details

Contact Phone Number

Contact Mobile Number

Contact Email Address

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