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Insurance Agency Client Intake Form

Insurance Agency and Broker Resource

Onboard a new insurance-agency client with an intake form for producers, account managers, and brokers. Collect household or entity contacts, current policy schedule, carriers and expiration dates, operations or personal-lines snapshot, loss-run status, and how the client will share documents. A complete intake shortens the first renewal and reduces E&O from missing lines. Not insurance advice and not an application—carrier applications still must be signed. Confirm current E&O and privacy procedures for storing applications and driver data.

Insurance Agency Client Intake Form form template preview

Key Benefits

Capture legal names and who is authorized to bind
List every current policy, carrier, and expiration
Note operations, locations, and personal-lines snapshot
Record whether loss runs have been ordered
Set document-sharing and meeting preferences
Reduce missed lines at the first renewal

Common Use Cases

Agencies taking over an account from another brokerNew commercial clients at first appointmentPersonal-lines households consolidating policiesAccount managers building an AMS profileProducers preparing a first marketing submissionCross-sell reviews after a life event or acquisition

Frequently Asked Questions

Is this intake a substitute for an ACORD application?
No. Intake starts the agency file. Binding still requires the carrier’s current application, signed by the named insured, with accurate exposures. Use this form to know what to request next.
What should we collect on current policies?
Line of business, carrier, policy number, limits if known, expiration date, and whether the client has declarations PDFs. Expiration dates drive the first work plan.
How do we handle driver or medical data?
Collect only what you need for the lines you will quote, store it under your privacy and E&O procedures, and use FCRA-compliant processes when MVRs are ordered through a CRA.
Is this insurance advice?
No. It is an agency onboarding form. Coverage recommendations belong in a licensed review of applications and policies, not on this intake alone.

Checklist

Client

Client legal name, DBA, contacts, and who may bind coverage
Required

Entity type and FEIN if commercial.

Policies

Current policy schedule: line, carrier, number, and expiration
Required

Ask for declarations PDFs.

Exposures

Operations narrative or personal-lines household snapshot
Required

Locations, vehicles, and headcount at a high level.

Claims

Whether currently valued loss runs have been ordered and from whom
Required

List prior carriers if known.

Contracts

Customer or landlord contracts that dictate insurance terms

AI and limit requirements.

Advisors

CPA, attorney, or prior-agent contacts the client authorizes

Needed for loss-run or application signatures.

Service

Portal vs email document sharing and meeting cadence
Required

Who receives certificates day-to-day.

Authorization

Signed permission to obtain loss runs and store application data
Required

Follow your E&O and privacy procedure.