Policy Change Request

The following form is provided to you for making changes or requests on your existing policies. By submitting this form you understand that no coverage or premium adjustment of any kind is bound until you receive written notice from us.

Policy Change Request

* indicates required fields

General Information

Name*

Company Name (If For a Business)

Email*

Phone*

Current Insurance Information

Insurance Company Name

Policy Number

Policy Expiration Date

Date You Would Like Changes to Take Effect

Describe Requested Changes

Name

This field is for validation purposes and should be left unchanged.

We Want Your Opinion!

Customer Reviews

Always helping us save money.

Chase S

Great experience with a quote that saved me money!!

Alison R

Josh Huff was excellent and reviewing my current coverage, making suggestions...

Tom W

Insurance

About

Policy Service

Springfield Office

2001 West Monroe Street
Springfield, Illinois 62704

Phone: (217) 441-2020

Office Hours:

Mon-Fri: 9:00am-5:00pm
Sat-Sun: Closed

Peoria Office

6907 Knoxville Ave
Peoria, Illinois 61614

Phone: (309) 691-6805

Office Hours:

Mon-Fri: 9:00am-5:00pm
Sat-Sun: Closed

Geneseo Office

795 W Elm Street
Geneseo, Illinois 61254

Phone: (309) 944-6487

Office Hours:

Mon-Fri: 9:00am-5:00pm
Sat-Sun: Closed

Blue Oak Insurance Agency provides auto, home, life, and business insurance to all of Illinois, including Springfield, Chatham, and Rochester.

If you are requesting information regarding your Medicare health plan options, by submitting your information, you agree that an authorized representative or licensed insurance agent may contact you by phone or email to answer your questions or provide additional information about Medicare Advantage plans, Prescription Drug Plans or Medicare Supplement Insurance plans. This is an advertisement for insurance.