VPI Forms

Note: Each form on this page is a PDF file. When selected, the PDF may either open in a new window or download automatically. See below for more information about PDFs.

Refer-A-Friend Form

• Refer-A-Friend Form (32 KB)

Claim Forms

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

Note: Current VPI policyholders can log on to the Policyholder Portal to download claim forms personalized with your name, policy number and pet’s name.

Learn 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 (74 KB)

Medical Benefit Schedules

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

Pet Well Care Protection Benefit Schedules

• Pet Well Care Protection Core Coverage (24 KB)
• Pet Well Care Protection Premier Coverage (24 KB)
• Vaccination & Routine Care Coverage (26 KB)

Policy Transfer Form

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

• Policy Transfer Form (132KB)

Hospital Forms

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