Please complete the initial brief application and submit. We can email, fax, or mail you a full application once your License is verified or you can print an application form below.
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*By submitting you are giving permission for FPA/FPALDIC to contact you by email.
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Physicians application can be printed and mailed, faxed, or emailed!
Email to: george.brew@fpalegaldefense.com, fax to: 904-854-6057
Email to: george.brew@fpalegaldefense.com, fax to: 904-854-6057