To notify us, you may:
- Submit the form online by clicking Submit below
- Print the form and fax to 1-800-758-3635
- Print the form and mail to:
Healthcare Providers Service Organization
1100 Virginia Dr., Ste. 250
Ft. Washington, PA 19034
You will receive a response within three business days from our receipt of your incident report. If you need to speak to someone immediately regarding an incident, please call 1-800-982-9491, Monday through Friday, from 8:00 a.m. to 6:00 p.m., ET.