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Download Full Application Forms

There are potentially three forms for you to complete:

  1. Surgeon Application Form
  2. Letter of Authority*
  3. Specialty Specific Form

Please click to download the relevant forms and return them, completed, to Indigo Indemnity Limited at Indigo@m-i-c.co.uk for a full, accurate quote.

Your Specialty

If your specialty is not listed, please submit the Surgeon Application Form and Letter of Authority which will enable our team to pursue a full accurate quote for you.

INDIGO is in a collaborative relationship with OTSIS and PRASIS for Orthopaedic and Plastic Surgery colleagues respectively so please contact either Otsis@m-i-c.co.uk or Prasis@m-i-c.co.uk for further details.

Your Forms

Please download the full surgeon application form: Surgeon Application Form

Along with this supplementary questionnaire relating to your specialty: Anaesthetic Supplementary Questionnaire

Along with this supplementary questionnaire relating to your specialty: Cardiac or Cardiothoracic Supplementary Questionnaire

Along with this supplementary questionnaire relating to your specialty: Cardiology Supplementary Questionnaire

Along with this supplementary questionnaire relating to your specialty: Gastroenterology Supplementary Questionnaire

Along with this supplementary questionnaire relating to your specialty: General Surgery Supplementary Questionnaire

Along with this supplementary questionnaire relating to your specialty: Gynaecology Supplementary Questionnaire

Along with this supplementary questionnaire relating to your specialty: Opthalmology Supplementary Questionnaire

Along with this supplementary questionnaire relating to your specialty: Oral, Maxillofacial, Head or Neck Supplementary Questionnaire

Along with this supplementary questionnaire relating to your specialty: Radiology Supplementary Questionnaire

Along with this supplementary questionnaire relating to your specialty: Urology Supplementary Questionnaire

Along with this supplementary questionnaire relating to your specialty: Vascular Supplementary Questionnaire

Please download the authority form*: Letter of Authority

*In order for a definitive quote to be provided, we need to obtain a certificate of good standing and a claims record from your current indemnity provider. This is entirely routine and does not commit you to anything and is something which you can do yourself or, if you complete this form and send it to us, we will do on your behalf.