General Liability, Automobile Liability, and Property Insurance Certificate Request Form
This form should not be used to request Healthcare Professional Liability certificates or claim histories. For HPL information, email insurance@uabmc.edu.
This is the UAB individual completing this form.
This is the external individual or organization requesting proof of coverage. This is typically the other party to the contract or agreement.
Please select the method we should use to provide the certificate to the Certificate Holder.
If requesting a property certificate, please provide a description, location, and value for the property.