Dominion Insurance Services: Where the Answers Are
370 Park Street, Suite 8, Moraga CA. 94556
341 S. Main, Suite 100, Alpine UT. 84004
888.313.9977(t) ~ 925.313.9978(f)
info@dominioninsurance.com
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Treatment Guardian Endorsement

In consideration of the premium charged, it is hereby understood and agreed that the definition of Professional Services is amended to include:

Treatment Guardian

Section V. DEFINITIONS is amended to include the following:

" Treatment Guardian " means a guardian whose authority extends only to providing consent for mental health treatment protocols perscribed by a licensed mental health provider.

The services performed by a Treatment Guardian does not mean one who directly provides medical or mental health treatment.

All other terms and conditions of the Policy remain unchanged.

Treatment Guardian Endorsement (05/19)