Submit Customer

Thank you for introducing Rentguard services. To refer a potential customer please fill in and submit the brief form below and we will contact the interested customer to discuss their insurance requirements and supply them with a competitive and no obligation quote. Mandatory fields are marked *

This form can only be used by registered Rentguard agents. Not a Rentguard agent? Interested in becoming one? Click here to register

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For information on how we use your personal data please refer to our Privacy Notice

Interested customer details

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Title

Mr Mrs Miss Ms Dr

First Name*

Last Name*

Telephone*

Email*

Best time to call

Please select 09:00 to 10:00 10:00 to 11:00 11:00 to 12:00 12:00 to 13:00 13:00 to 14:00 14:00 to 15:00 15:00 to 16:00 16:00 to 17:00 17:00 to 17:30

Insurance renewal date (dd/mm/yyyy)

Customer would like to be contacted closer to their renewal date

Area of interest

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Property address

Property postcode

Residential Landlord insurance

Commercial Property insurance (Commercial & Residential combined)

Owner Occupier insurance

Tenant Contents insurance

Legal Expenses and Rent Guarantee

UK Holiday and Second Homes insurance

Professional Indemnity insurance

Property Portfolio insurance

Agency / Introducer details

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Agency representative's name

Agency name*

Agent number*

By submitting this form you confirm that customer has read and agrees to the site privacy policy and that the details provided will be passed to Rentguard who will use the information to make contact by phone/email about general insurance.