Helpful Forms
In order to present your case effectively, we will need you to provide with specific and accurate information.
A representative from our office will instruct you on which forms you’ll need to fill out.
New Client Intake Form – Use this if you are new are a new client.
Appeals Form – Use this if your claim has already been denied.
Authorization to Release Medical Information
Please note: You will need to print these forms, fill them out, and then return them to us in person, via fax, or via email.
Fax: (888) 371-2141
