midwivesmedmal Quoting Zest Midwives Med Mal Scheme

Have you previously obtained cover through SK Underwriting and do you wish to renew your policy?

Yes No

Please provide details of the midwife to be named on the policy

Please note, if you are a company each midwife who can act as the lead midwife for a delivery must have their own individual policy

First name

Surname

Please enter their Zest PIN

Please enter their Nursing and Midwifery Council (NMC) PIN

When did the midwife start Independent Practice?

Has the midwife qualified as or revalidated their midwife qualification in the last 3 years?

Yes No

Is the midwife affiliated to any NHS Trust(s)?

Yes No

Please select the affiliated NHS Trust

Any other affiliated NHS Trust(s)?

Yes No

Please select the affiliated NHS Trust

Any other affiliated NHS Trust(s)?

Yes No

Please select the affiliated NHS Trust

Any other affiliated NHS Trust(s)?

Yes No

Has the midwife suffered any loss or circumstance which has, or might have given rise to a claim under this type of insurance during their time of practice or during the last 10 years? (whichever the lesser)

Yes No

Will any midwife undertake any Complimentary Therapies other than:

Acupressure

Alexander Technique
Aromatherapy

Bach Flower

Clinical Hypnosis

Counselling

Craniosacral therapy

Herbal Medicine
Homeopathy

Hopi Ear Candles
Hypnotherapy

Lactation Consultant
Massage therapy

Meditation
Moxibustion
Naturopathy

Nutrition & Exercise

Qi Gong & Tai Chi
Reflexology /Reflex Zone
Reiki
Sound Therapy

Tongue Tie

Yoga

Please confirm:

Yes No

This list of Complimentary Therpaies display is included as standard in your policy.

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