General Request Form - Follow Up Client Name* First Last Business NameIf applicable. Type of Policy*Which policy are we looking at? Either type of policy (Auto, Home, Business) or policy number.Type of Request*BillingCancellationClaims Support (open claim)Claims Counsel (no claims made yet)Follow Up (open request/task)General Request or QuestionProof of InsuranceRenewal / RequoteSales: New Client or Lead Follow UpChoose category of request. Complete Request Details*Add the details of the request.Turnaround Time*What is the timeframe they can expect to hear from us? *Use our template: End of Day (EOD) - June 6 (Date)Contact Method*Email - on fileText - # on fileEmail and Text - info on fileScheduling phone/in office appointmentNo Follow Up Requested / Wait for Carrier ConfirmationWhat is the preferred contact method that we'll reach out? To avoid phone tag, we'll start with email or text and go from there. Contact Method DetailsIf the phone number or email are different than what we have on file, or need to be clarified, please include here. Attach any related documentsMax. file size: 98 MB.Attach any related documents or emails. NTI Team Member Name*Who is filling out this form? Email for Confirmation* Please add the email address we can send confirmation of this request.
