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Forms

Our goal is to provide you with the best representation possible.  In order for use to accomplish this, we’ll need very accurate and specific details from you.  The following forms will assist you.

Please contact our office if you have questions regarding which forms to complete.

New Client Intake Form

If you are a new client you will need to complete this form.

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Appeals Form

If your claim has been previously denied, please complete this form.

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Authorization to Release Medical Information

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Please download and complete the appropriate form.  Once completed, you can return it to our office in person, via fax, or via email.