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Coppermark Public Adjusters Oklahoma LogoCoppermark Public Adjusters Oklahoma Logo
  • HOME
  • ABOUT
  • SERVICES
  • CLAIMS
    • Storm Damage
    • Earthquake Damage
    • Large Loss Claims
    • Tile Roof Damage
    • Wood Shake Roof Damage
  • BLOG
  • CONTACT
  • NEW CLIENTS
  • CLIENT PORTAL
Client Intake FormFraziercreative2021-09-21T09:53:59-05:00

"*" indicates required fields

Client Information

Policyholder Name*
Loss Address*
Mailing Address

Additional Contact

Contact Name

Insurance Information

MM slash DD slash YYYY
MM slash DD slash YYYY

Insurance Adjuster, Supervisor, or Carrier's Appraiser Contact

Checklist of items needed for consideration of PA or Appraisal

  • Insurance carrier's most recent scope
  • Contractor's most recent scope
  • Insurance company correspondence (letters, emails, etc.)
  • Photos-Before, During, and/or After Build
  • Policy and Endorsements covering the date of loss
Please email these documents to claims@coppermark.claims. If you have photos, we will send you a link to upload them. If you have a photo link, please put it in the claim description box above.
This field is for validation purposes and should be left unchanged.

Address

609 S. Kelly, Ste. F-3, Edmond, OK 73003

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Phone

Main Office: (855) 45-CLAIM

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Email

claims@coppermark.claims

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