Before filling please read below instructions carefully.
Your employer must be an existing member of PDT. Coverage must be for a group of 2 or more. New members should contact PDT directly to obtain coverage.
- Download the Form: Use the download button to access the form.
- Complete the Form: Fill in the required information directly within the PDF.
- Upload the Completed Form: After completing the form, download the filled file and upload it in the “upload filled file” section below.
- Submit Your Information: Provide your name and email address, then upload all files to complete the submission.
