Coterie Local Page Intake Form

To provide the best experience for you and your customers, make sure to carefully enter the requested information accurately. The more info you provide, the more robust your Find an Agent page will be.

Your page will be designed and published on our site within 3 weeks of your form submission.


Please email britni@coterieinsurance.com with any questions. Thank you!

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* 1. Agency Details

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* 2. Agent Image

PNG, JPG, JPEG file types only.
Choose File

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* 3. QuickQuote Link (Access via you Account tab in Coterie Dashboard. If unable to locate, please email britni@coterieinsurance.com for assistance)

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* 4. Agency Website Address (If you don't have a website, please provide the link to your agency's Facebook or LinkedIn profile)

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* 5. Primary Business Email Address

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* 6. Hours of Operation: Please enter your hours of operation for each day listed below, if CLOSED, please enter closed. (EX. 8-5, 10-6, 12-5 etc.)

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* 7. Testimonials for Find an Agent Page Information - 

Please provide up to three customer testimonials for us to upload to your Find an Agent page. These testimonials can be taken from your Google My Business page, Facebook, Yelp or any other source you have. (Please do not include quotation marks. Those will be added automatically)

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* 8. About Us on your local "Find an Agent" page

Your Find an Agent page will display an About (Your Agency Name) section. Please share pertinent information about your agency with potential customers - such as the areas you service, types of insurance products offered, additional languages, what someone can expect when scheduling an appointment or visiting your office. This is your platform to win over potential customers and share what makes your agency unique.

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