Request For Medical Docs/Bills From Dr.

A form letter requesting medical documents and bills from a physician providing treatment to a claimant, sent with a medical authorization.

BROWSE RELATED DOCUMENT LISTINGS

Request For Medical Docs/Bills From Dr. (Spanish)

A form letter requesting medical documents and bills from a physician providing treatment to a claimant, sent with a medical authorization.

State Drunk Driving Laws Illegal Blood Alcohol Content

Illegal blood alcohol content per state drunk driving laws.

Employment, Wage & Med. Authorization

An employee authorization form allowing release of employment, wage and medical information to another party.

Employment, Wage & Med. Authorization (Spanish)

An employee authorization form allowing release of employment, wage and medical information to another party.

Inquiry Form - Index System

This inquiry form requests claim details for a third party using an Index System.

Medical Authorization (HIPAA Compliant)

Authorization form for disclosure of medical records, in compliance with HIPAA requirements.

Medical Authorization (HIPAA Compliant) (Spanish)

Authorization form for disclosure of medical records, in compliance with HIPAA requirements.