Consumer Protection Forms
This is one of several pages linking to a central repository of forms used by TDI customers. Use the search or Forms by Type links on the Forms Home Page or scan through our form listings.
PDF Files - If you do not have Adobe Acrobat® Reader installed on your system, you may download a free viewer at: http://get.adobe.com/reader/.
| TDI Form Number | Description | File Format |
|---|---|---|
| CP012 | CP012 - Online Complaint Form | HTML - ONLINE |
| CP012 | CP012 - Online Complaint Form [En Español] | HTML - ONLINE |
| TDI Form Number | Description | File Format |
|---|---|---|
| CP003 | TDI Speakers Bureau Request Form TDI Speakers Bureau Request Form |
|
| CP012 | Complaint Form Complaint Form - English |
|
| CP012 | Complaint Form Complaint Form - English |
RTF |
| CP012 | Physician and Health Care Provider Information Attachment A - Physician and Health Care Provider Information |
RTF |
| CP021 | Certificate of Compliance of Advertising Advertising Compliance Form |
WORD |
| CP021 | Certificate of Compliance of Advertising Advertising Compliance Form |
|
| CP024 | Advertising Transmittal Form Transmittal Form for Advertising Filings |
|
| CP026 | CHAP Speakers Bureau Request Form CHAP Speakers Bureau Request Form |
|
| LHL619 | Health Insurance Mediation Request Form Request health insurance mediation |
- Race-based Pricing Settlement Claim Form - Form for eligible policyholders to claim additional benefits pursuant to race-based pricing settlements negotiated by the California, Florida, Georgia, Ohio, and Texas Departments of Insurance.
En Español
| Número del Formulario de TDI | Descripción | Formato del Archivo |
|---|---|---|
| CP012 | Spanish Complaint Form Complaint Form - En Español |
RTF |
| CP012 | Spanish Complaint Form Complaint Form - En Español |
Previous Page | Next Forms Page
For more information contact:
