Medical Cost Projections Order Form

Records needed for Cost Projections:

  • Narrative reports from treating physicians
  • Operative reports
  • Office notes from treating specialists
  • Bills from MD offices, therapy offices, surgical procedures
  • Diagnostic tests
  • Deposition transcripts (if available)
  • ER reports (if available)

 

*Please have all records available for upload prior to proceeding with order form.  Upload required in step 3.

1 Contact Information
2 Claim Information
  •  
  • Patient/Client Information

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