Insurance · community shared

Policy Change Request — shared by the community

Rachel O. shared this 20-question build with 4 conditional rules already wired up. Test it below, then take a copy.

A ready-to-use insurance form for small teams who need a reliable intake process: 20 questions, 2 pages, 4 conditional rules.

Shared by
Rachel O. · Events coordinator
Questions
20
Replies
23
Copies taken
588
See the library version

policy change request form, mid-term adjustment form insurance, insurance amendment request form, change of details form insurer, add driver to policy form, policy endorsement request form, policy change request, policy change request forms, policy change request template, online policy change request, policy, policies, change, changes, request, requests, which, changing, details, insurance form, quote form, policy form, claim form, insurance claim, coverage request, broker form, policy change, renewal form, insurance application, policy change request example, shared policy change request

Live preview and test console

This is the real form. Answer it to test the flow — nothing is sent or stored.

Page 1 of 2Policy and change type

Which policy is changing

Include your country code.

Are you the policyholder?

This template runs as a straight sequence — no branching rules.

Works for you? Take Rachel O.'s copy into your own workspace — questions, rules and settings included.

Who this template is for

Policy Change Request is built for small teams who need a reliable intake process who need to collect the same complete information from everyone.

  • Small teams who need a reliable intake process working in insurance.
  • Teams who need to collect the same complete information from everyone without writing code or paying for a custom build.
  • Anyone replacing chasing missing details over email with one structured record per enquiry.
  • Respondents are the people you send it to — the form asks them 20 questions across 2 screens.
  • Mobile-heavy audiences, thanks to the one-question-per-screen card layout.

Why this form is useful

It removes the cost of chasing missing details over email and turns each submission into a record your team can act on immediately.

  • 9 questions are required, so submissions arrive complete instead of needing a follow-up email.
  • It collects a verified email address so replies and confirmations land.
  • It captures a phone number for urgent follow-up.
  • It accepts a document or photo upload as evidence.
  • It pins the request to a specific date.
  • It captures a full postal address.
  • It allows multiple selections without free text.
  • Conditional logic hides 4 questions until they are relevant — shorter forms convert better than long ones.

How to use this template

From copy to live form is a few minutes of work, and every step is reversible.

  1. 1Press “Use this template” — a fresh copy of Policy Change Request lands in your workspace, ready to edit.
  2. 2Rename or delete any question, and change what is required. Nothing here is fixed.
  3. 3Open Notifications and add the email addresses that should be alerted on each submission; add an auto-reply to the respondent if the form collects an email address.
  4. 4Check the upload limits on the file question so respondents can attach what you actually need.
  5. 5Publish it, then either share the link directly or paste the embed snippet into your site — the embedded form resizes to fit and loads no marketing or advertising trackers.
  6. 6Watch responses land in Submissions, where you can filter, label and export them to CSV or PDF.

Logic and conditions blueprint

Exactly how this form behaves as it is answered — 4 conditional rules ship with it.

  • Features conditional validation: if “What would you like to change?” is Add or remove a named driver, “Driver name, date of birth and licence details” becomes mandatory before the form can be sent.
  • Features conditional validation: if “What would you like to change?” is Change of address, “New address” becomes mandatory before the form can be sent.
  • Features conditional validation: if “What would you like to change?” is Cancel the policy, “Why are you cancelling?” becomes mandatory before the form can be sent.
  • Features conditional validation: if “Are you the policyholder?” is No, I am acting for them, “Your name and your authority to act” becomes mandatory before the form can be sent.
  • All 4 rules are editable in the Logic tab, and the built-in checker warns about rules that contradict each other.

What this form asks

Page 1 — Policy and change type

  • Policy numberrequired
  • Policyholder namerequired
  • Contact numberrequired
  • Email addressrequired
  • Are you the policyholder?required
  • Your name and your authority to act
  • What would you like to change?required
  • From what date should the change apply?required

Page 2 — Details of the change

  • New address
  • Date of the move
  • New vehicle registration, make and model
  • Registered keeper of the new vehicle
  • Driver name, date of birth and licence details
  • New level of cover or sum insured
  • Updated business details
  • Why are you cancelling?
  • How should any difference be settled?required
  • Anything else we should know?
  • Upload any document that supports the change
  • Confirmationrequired

Conditional logic in this build

  • WhenWhat would you like to change?is Add or remove a named driver, requireDriver name, date of birth and licence details”.
  • WhenWhat would you like to change?is Change of address, requireNew address”.
  • WhenWhat would you like to change?is Cancel the policy, requireWhy are you cancelling?”.
  • WhenAre you the policyholder?is No, I am acting for them, requireYour name and your authority to act”.

Questions about this shared form

Is the change effective when the form is submitted?

No. The confirmation makes that explicit: a change applies once the insurer confirms it, and your written confirmation is what the customer should rely on.

How does it relate to the quote request?

The Insurance Quote Request Form is for new cover. This form adjusts a policy that already exists, which needs the policy number and an effective date.

Can a broker complete it for a client?

Yes. The authority question captures who is asking and on what basis, which is worth recording even when the relationship is obvious.

Should the form show the cost of the change?

No. Pricing a mid-term adjustment is the insurer's, so capture the preference for settling any difference and confirm the figure afterwards.

Is the Policy Change Request template free to use?

Yes. You can preview and test Policy Change Request on this page without an account, and take a copy into your own HelloForms workspace on the free plan. There is nothing to install and no card required to publish it.

What does the Policy Change Request template ask for?

It asks 20 questions across 2 pages, 9 of which are required. Every question is listed in full further down this page, and each one can be renamed, reordered, made optional or deleted after you copy the template.

Can I edit the Policy Change Request form after copying it?

Yes — the copy is entirely yours. Change wording, add or remove questions, switch between the classic and card layouts, restyle it to match your brand, and set who gets notified on each submission.

How does the conditional logic in this insurance form work?

4 conditional rules ship with the template: Features conditional validation: if “What would you like to change?” is Add or remove a named driver, “Driver name, date of birth and licence details” becomes mandatory before the form can be sent. Features conditional validation: if “What would you like to change?” is Change of address, “New address” becomes mandatory before the form can be sent. Features conditional validation: if “What would you like to change?” is Cancel the policy, “Why are you cancelling?” becomes mandatory before the form can be sent. All rules are editable in the Logic tab.

Where do responses to the Policy Change Request form go?

Submissions land in your workspace under Submissions, where you can search, filter, label and export them to CSV or PDF. You can also email a notification to your team on every submission and send the respondent an auto-reply.

Can I embed the Policy Change Request form on my own website?

Yes. Publish the form and paste the embed snippet into any page or share the direct link. The embedded form resizes to fit its container and loads no advertising or marketing trackers inside the iframe.

Can respondents upload files?

Yes. This template includes a file upload question, so respondents can attach documents or photos with their answers. You can adjust the accepted file types and size limits on that question.