Download Forms

Select a state from the list below to download your claim form. Be sure to fill out the form in its entirety and follow any specific instructions for your state.

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Claims Submission Checklist

To facilitate a short claim turnaround time, please make sure you do the following:

  1. You fill out and sign Section 1
  2. The veterinarian or hospital representative fills out and stamps Section 2
  3. Mail or fax completed claim plus all original receipt(s) for all visits noted on the claim form to Mail:

P.O. Box 599500,
San Antonio, Texas 78259-9500
Fax: 314-982-3312