Client Approval

Please complete the fields below to submit a prospective client for credit and workers compensation underwriting.

  • Your Information

  • Client Information

  • Credit Information

  • Affordable Care Act Surcharge

  • This percentage will appear as an additional line item on the invoice separate from your standard mark-up or bill rate.
  • Work Comp Info (If Available)

  • Additional Client Info (Optional)

  • Accepted file types: doc, docx, pdf, jpg, ppt, pptx, xls, xlsx.
  • This field is for validation purposes and should be left unchanged.