VPI Pet Insurance Forms

Refer-A-Friend Form

• Refer-A-Friend Form (32KB)

Claim Forms

To download a claim form, please select your state of residence from the table below.

Personalized Claim Forms

Policyholders can log on to the Policyholder Portal to download claims forms with your name, policy number and pet’s name.

Need Help Filing Claim?

The VPI Knowledge Base can show you how to file a claim.

Review Form

This form may be used as a cover sheet for your request to review a completed claim or an excluded condition.

• Review Form (74KB)

Medical Benefit Schedules

• Superior Plan Benefit Schedule (104KB)
• Standard Plan Benefit Schedule (100KB)
• Avian and Exotic Plan Benefit Schedule (97KB)

Plans available in limited states; for your state, visit Plans & Coverage

• Major Medical Plan Benefit Schedule (90KB)
• Medical Plan Benefit Schedule (74KB)
• Injury Plan Benefit Schedule (50KB)
• Feline Select Coverage Form (65KB)

CareGuard^SMBenefit Schedules

(Formerly Pet Well Care Protection)

• CareGuard Core Coverage (24KB) (Formerly Pet Well Care Protection Core)
• CareGuard Premier Coverage (24KB) (Formerly Pet Well Care Protection Premier)

Policy Transfer Form

This form may be used to request your pet’s policy be transferred to a new owner.

• Policy Transfer Form (264KB)

Hospital Forms

• Physical Examination Record Form (165KB)
• Hospital Sign-In Sheet (14KB)

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