Request a Broker Visit

At SUREWiSE, we’re all about forming long lasting relationships with our clients.

Did you know you can request a visit from one of SUREWiSE’s qualified & experienced insurance brokers online?

Simply complete the ‘Request a Broker Visit Form’ below and one of insurance brokers will contact you to arrange an appointment. Alternatively, please contact us on 1800 273 256.

You can also request a Skype video call online if that’s a more convenient option for you.

Request a Broker Visit Form

  • Your Details

    This section of the form captures information about you so we can identify who you are and contact you to schedule a visit from one of our qualified and experienced insurance brokers.
  • Are you an existing SUREWiSE client?
  • If you are an existing SUREWiSE client, what is your client code (refer to your invoice)?
  • Enter your business or company name
  • What type of business do you operate and in what industry?
  • Enter the first name and surname of the person we should contact
  • Enter the contact person's email address
  • Enter the contact person's phone number (including area code)
  • Enter your website address
  • Enter the physical address for your business
  • Preferred Visit Details

    This section of the form captures information about the nature of your request for one of our qualified and experienced insurance brokers to visit you.
  • What is the primary reason you require one of insurance brokers to visit you?
  • What is your preferred date for a broker visit?
    MM slash DD slash YYYY
  • What is your preferred time for a broker visit?
  • By ticking the box below, you acknowledge your request for a broker visit is a request only and SUREWiSE Pty Ltd (SUREWiSE) may not be able to arrange for one of our brokers to physically visit you or on your preferred date or at your preferred time. You also acknowledge that currently, SUREWiSE can only consider requests for a physical broker visit within South Australia (but note there are times when our brokers travel interstate). You also agree and declare that you are authorised to request a broker visit on behalf of the business or company you have named on this form and you agree to be contacted by one of our qualified and experienced insurance brokers.
  • This field is for validation purposes and should be left unchanged.