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Click on the appropriate application form in the list below to open the application in a new window.
Note: Adobe Acrobat Reader (version 6.0 or higher) is required to view and print these applications. If you do not have Acrobat Reader, you can download it, free of charge from the Adobe website by clicking here.
Please review the form to ensure you have selected the correct application, then print the document and fill it out in its entirety.
Return the completed application along with payment in full for the annual premium to:
Bill Beatty Insurance Agency, Inc.
1202 Richardson Dr, Suite 100
Richardson, Texas 75080
Payment methods accepted: Credit card, check and money order
If you are making payment by credit card, you have the additional option of submitting your application along with the completed credit card authorization form via fax to:
(972) 437-3759
If you have any questions, please call:
Toll Free: (800) 451-8358
Dallas Area: (972) 644-4281
Allied Health Professional
Certified Nurse Anesthetist
Dental Assistant
Dental Hygienist
Dietitian / Nutrition Consultant
Health Care Arts
Licensed Physical Therapist Assistant
Medical Assistant
Medical Technician
Nurse
Nurse Practitioner
Occupational Therapist / COTA
Pharmacist
Pharmacy Technician
Physical Therapist (Employed)
Physical Therapy Business
Rehabilitation Counselor
Speech and Hearing Therapist
Student Blanket Policy
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