4 - Litigation
Case Status
LOP FORM
LOP MP – 1 | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 State Farm Fire Claims | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Aaron Jones
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Baylor Scott & White Medical Center | |
LOP MP – 2 Accident Centers of Texas (No Record) | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 GAINSCO Auto Insurance | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 No Ins | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Baylor Scott & White Medical Center | |
Request For Medical Records and Affidavit MP - 2 Accident Centers of Texas (No Record) | medical record provider requested |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Baylor Scott & White Medical Center | |
Reduction Request MP – 2 Accident Centers of Texas (No Record) | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Andrea Johnson
5 - Discovery
Case Status
LOP FORM
LOP MP – 1 Erin E. Shrago, Psy.D., LLC | |
LOP MP – 2 Dr. Randy Gibson | |
LOP MP – 3 Highland Dermatology | |
LOP MP – 4 Dr. Stephanie Hiraki | |
LOP MP – 5 CareNow Urgent Care | |
LOP MP – 6 Doctor Care Clinic | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 EarthX | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 5 - Discovery
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Erin E. Shrago, Psy.D., LLC | |
Request For Medical Records and Affidavit MP - 2 Dr. Randy Gibson | |
Request For Medical Records and Affidavit MP - 3 Highland Dermatology | |
Request For Medical Records and Affidavit MP - 4 Dr. Stephanie Hiraki | |
Request For Medical Records and Affidavit MP - 5 CareNow Urgent Care | |
Request For Medical Records and Affidavit MP - 6 Doctor Care Clinic | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Erin E. Shrago, Psy.D., LLC | |
Reduction Request MP – 2 Dr. Randy Gibson | |
Reduction Request MP – 3 Highland Dermatology | |
Reduction Request MP – 4 Dr. Stephanie Hiraki | |
Reduction Request MP – 5 CareNow Urgent Care | |
Reduction Request MP – 6 Doctor Care Clinic | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
- PIP Coverage
Antonio Shelton
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Baylor Scott&White Medical Center | |
LOP MP – 2 Accident Centers of Texas (No Record, Client cancelled appointment) | |
LOP MP – 3 MDN Injury Care | lop provider sent | lop provider received
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | | lor received
LOR 3rd Party – 1 GAINSCO Auto Insurance | lor sent | lor received
LOR 3rd Party – 2 | | lor received
LOR 3rd Party – 3 No Ins | | lor received
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Baylor Scott&White Medical Center | |
Request For Medical Records and Affidavit MP - 2 Accident Centers of Texas (No Record, Client cancelled appointment) | |
Request For Medical Records and Affidavit MP - 3 MDN Injury Care | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Baylor Scott&White Medical Center | |
Reduction Request MP – 2 Accident Centers of Texas (No Record, Client cancelled appointment) | |
Reduction Request MP – 3 MDN Injury Care | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Antonio Spencer
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Dr Bryan Weddle | |
LOP MP – 2 Dr. Charles Willis, M.D, P.A. | |
LOP MP – 3 CVS Pharmacy | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Health Scope | |
LOR 3rd Party – 1 American Access Casualty Company | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Dr Bryan Weddle | |
Request For Medical Records and Affidavit MP - 2 Dr. Charles Willis, M.D, P.A. | |
Request For Medical Records and Affidavit MP - 3 CVS Pharmacy | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Dr Bryan Weddle | |
Reduction Request MP – 2 Dr. Charles Willis, M.D, P.A. | |
Reduction Request MP – 3 CVS Pharmacy | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
April Adeoye
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Revive My Spine | lop provider sent |
LOP MP – 2 MRI Centers of Texas | lop provider sent |
LOP MP – 3 Dallas Radiology | lop provider sent |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Alinsco Insurance | |
LOR 3rd Party – 1 GEICO County Mutual Insurance Company | lor sent |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Revive My Spine | medical record provider requested |
Request For Medical Records and Affidavit MP - 2 MRI Centers of Texas | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 3 Dallas Radiology | medical record provider requested |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Revive My Spine | |
Reduction Request MP – 2 MRI Centers of Texas | |
Reduction Request MP – 3 Dallas Radiology | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Astrid Ulloa
2 - Gathering Medical Records
3rd party denied liability
Case Status
LOP FORM
LOP MP – 1 Parkland Hospital | |
LOP MP – 2 Core Wellness & Rehab Center | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party AssuranceAmerica | |
LOR 3rd Party – 1 GeiCO County Mutual Insurance Company | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Parkland Hospital | |
Request For Medical Records and Affidavit MP - 2 Core Wellness & Rehab Center | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Parkland Hospital | |
Reduction Request MP – 2 Core Wellness & Rehab Center | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Asuncion, Luciano Alvarado
2 - Gathering Medical Records
3rd party accepted 100% liability.
Case Status
LOP FORM
LOP MP – 1 Revive My Spine (didn't went to this provider) | |
LOP MP – 2 HK Radiology | lop provider sent | lop provider received
LOP MP – 3 MRI Centers of Texas (DIDN'T WENT FOR IMAGING) | lop provider sent | lop provider received
LOP MP – 4 Epic Pain & Orthopedics | lop provider sent | lop provider received
LOP MP – 5 Mira Vista Pharmacy | lop provider sent | lop provider received
LOP MP – 6 Core Wellness & Rehab Center | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 State Farm | lor sent |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Revive My Spine (didn't went to this provider) | |
Request For Medical Records and Affidavit MP - 2 HK Radiology | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 3 MRI Centers of Texas (DIDN'T WENT FOR IMAGING) | |
Request For Medical Records and Affidavit MP - 4 Epic Pain & Orthopedics | | medical record provider received
Request For Medical Records and Affidavit MP - 5 Mira Vista Pharmacy | medical record provider requested |
Request For Medical Records and Affidavit MP - 6 Core Wellness & Rehab Center | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Revive My Spine (didn't went to this provider) | |
Reduction Request MP – 2 HK Radiology | |
Reduction Request MP – 3 MRI Centers of Texas (DIDN'T WENT FOR IMAGING) | |
Reduction Request MP – 4 Epic Pain & Orthopedics | |
Reduction Request MP – 5 Mira Vista Pharmacy | |
Reduction Request MP – 6 Core Wellness & Rehab Center | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Brandie Johnson
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Revive Injury and Rehab | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 Kroger Co | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Revive Injury and Rehab | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Revive Injury and Rehab | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Brantley, Christopher
Mediation
Case Status
LOP FORM
LOP MP – 1 Progressive Medical Evaluations | |
LOP MP – 2 67 Pain & Injury | |
LOP MP – 3 Mira Vista Apothecary | |
LOP MP – 4 MRI Centers of Texas | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party FEDERAL INSURANCE / Gallager Basset | |
LOR 3rd Party – 1 OLD AMERICAN COUNTY MUTUAL / Connect Insurance | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage Mediation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Progressive Medical Evaluations | |
Request For Medical Records and Affidavit MP - 2 67 Pain & Injury | |
Request For Medical Records and Affidavit MP - 3 Mira Vista Apothecary | |
Request For Medical Records and Affidavit MP - 4 MRI Centers of Texas | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Progressive Medical Evaluations | |
Reduction Request MP – 2 67 Pain & Injury | |
Reduction Request MP – 3 Mira Vista Apothecary | |
Reduction Request MP – 4 MRI Centers of Texas | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Britni Johnson
3 - Demand Pending
Case Status
LOP FORM
LOP MP – 1 MDN Injury Care | |
LOP MP – 2 MRI of Texas | |
LOP MP – 3 Actnow1 | |
LOP MP – 4 Dallas Radiology, P.A. | |
LOP MP – 5 North Texas X-Ray | |
LOP MP – 6 people First Pharmacy | |
LOP MP – 7 Baylor University Medical Center Dallas | |
LOP MP – 8 Momentum Spine & joint | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 Geico | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 3 - Demand Pending
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 MDN Injury Care | |
Request For Medical Records and Affidavit MP - 2 MRI of Texas | |
Request For Medical Records and Affidavit MP - 3 Actnow1 | |
Request For Medical Records and Affidavit MP - 4 Dallas Radiology, P.A. | |
Request For Medical Records and Affidavit MP - 5 North Texas X-Ray | |
Request For Medical Records and Affidavit MP - 6 people First Pharmacy | |
Request For Medical Records and Affidavit MP - 7 Baylor University Medical Center Dallas | |
Request For Medical Records and Affidavit MP - 8 Momentum Spine & joint | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 MDN Injury Care | |
Reduction Request MP – 2 MRI of Texas | |
Reduction Request MP – 3 Actnow1 | |
Reduction Request MP – 4 Dallas Radiology, P.A. | |
Reduction Request MP – 5 North Texas X-Ray | |
Reduction Request MP – 6 people First Pharmacy | |
Reduction Request MP – 7 Baylor University Medical Center Dallas | |
Reduction Request MP – 8 Momentum Spine & joint | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Britni Johnson
Case Status
LOP FORM
LOP MP – 1 Baylor University Dallas | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Baylor University Dallas | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Baylor University Dallas | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Chris Cline
5 - Discovery
Case Status
LOP FORM
LOP MP – 1 Desoto Injury Rehab | |
LOP MP – 2 SOAR Institute PLLC | |
LOP MP – 3 ASP Cares | lop provider sent | lop provider received
LOP MP – 4 MRI Centers of Texas | |
LOP MP – 5 Pain Clarity LLC | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party AAA | |
LOR 3rd Party – 1 Progressive County Mutual Insurance Company | lor sent | lor received
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 5 - Discovery
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Desoto Injury Rehab | |
Request For Medical Records and Affidavit MP - 2 SOAR Institute PLLC | |
Request For Medical Records and Affidavit MP - 3 ASP Cares | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 4 MRI Centers of Texas | |
Request For Medical Records and Affidavit MP - 5 Pain Clarity LLC | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Desoto Injury Rehab | |
Reduction Request MP – 2 SOAR Institute PLLC | |
Reduction Request MP – 3 ASP Cares | |
Reduction Request MP – 4 MRI Centers of Texas | |
Reduction Request MP – 5 Pain Clarity LLC | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Christian Torres Francisco's son
5 - Discovery
Case Status
LOP FORM
LOP MP – 1 Med Post Urgent Care Rockwall | |
LOP MP – 2 Baylor Scott&White Lake Pointe | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 5 - Discovery
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Med Post Urgent Care Rockwall | |
Request For Medical Records and Affidavit MP - 2 Baylor Scott&White Lake Pointe | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Med Post Urgent Care Rockwall | |
Reduction Request MP – 2 Baylor Scott&White Lake Pointe | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Christopher Brantley
5 - Discovery
Case Status
LOP FORM
LOP MP – 1 Dallas Radiology | |
LOP MP – 2 67 Pain & Injury | |
LOP MP – 3 Mira Vista Apothecary | |
LOP MP – 4 Foundation Physicians Group | |
LOP MP – 5 Renaissance Radiology | |
LOP MP – 6 Priority Imaging | |
LOP MP – 7 Progressive Medical Evaluations | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party USAA | |
LOR 3rd Party – 1 OLD AMERICAN COUNTY MUTUAL / Connect Insurance | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 5 - Discovery
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Dallas Radiology | |
Request For Medical Records and Affidavit MP - 2 67 Pain & Injury | |
Request For Medical Records and Affidavit MP - 3 Mira Vista Apothecary | |
Request For Medical Records and Affidavit MP - 4 Foundation Physicians Group | |
Request For Medical Records and Affidavit MP - 5 Renaissance Radiology | |
Request For Medical Records and Affidavit MP - 6 Priority Imaging | |
Request For Medical Records and Affidavit MP - 7 Progressive Medical Evaluations | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Dallas Radiology | |
Reduction Request MP – 2 67 Pain & Injury | |
Reduction Request MP – 3 Mira Vista Apothecary | |
Reduction Request MP – 4 Foundation Physicians Group | |
Reduction Request MP – 5 Renaissance Radiology | |
Reduction Request MP – 6 Priority Imaging | |
Reduction Request MP – 7 Progressive Medical Evaluations | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Cindy Thepsombandith
2 - Gathering Medical Records
3rd Party deny coverage.
Case Status
LOP FORM
LOP MP – 1 Accident Centers of Texas | lop provider sent | lop provider received
LOP MP – 2 Infinity Care Medical Group | lop provider sent | lop provider received
LOP MP – 3 North Texas X-Ray Services, Inc. | lop provider sent | lop provider received
LOP MP – 4 Prime Diagonstic Imaging (No record available) | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Progressive Insurance Company | |
LOR 3rd Party – 1 Infinity Insurance | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Accident Centers of Texas | |
Request For Medical Records and Affidavit MP - 2 Infinity Care Medical Group | |
Request For Medical Records and Affidavit MP - 3 North Texas X-Ray Services, Inc. | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 4 Prime Diagonstic Imaging (No record available) | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Accident Centers of Texas | |
Reduction Request MP – 2 Infinity Care Medical Group | |
Reduction Request MP – 3 North Texas X-Ray Services, Inc. | |
Reduction Request MP – 4 Prime Diagonstic Imaging (No record available) | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
- No PIP Coverage
D'Andra Parish-Warren
5 - Discovery
Case Status
LOP FORM
LOP MP – 1 Wellness Center of Texas | |
LOP MP – 2 MRI Centers of Texas | |
LOP MP – 3 Lakewood Anesthesia C/O EZ MED GROUP | |
LOP MP – 4 Uptown Radiology Associates | |
LOP MP – 5 Epic Pain & Orthopedics | |
LOP MP – 6 Preferred Imaging | |
LOP MP – 7 Code 3 ER & Urgent care at Mesquite | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Liberty Mutual | |
LOR 3rd Party – 1 Travelers Insurance | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 5 - Discovery
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Wellness Center of Texas | |
Request For Medical Records and Affidavit MP - 2 MRI Centers of Texas | |
Request For Medical Records and Affidavit MP - 3 Lakewood Anesthesia C/O EZ MED GROUP | |
Request For Medical Records and Affidavit MP - 4 Uptown Radiology Associates | |
Request For Medical Records and Affidavit MP - 5 Epic Pain & Orthopedics | |
Request For Medical Records and Affidavit MP - 6 Preferred Imaging | |
Request For Medical Records and Affidavit MP - 7 Code 3 ER & Urgent care at Mesquite | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Wellness Center of Texas | |
Reduction Request MP – 2 MRI Centers of Texas | |
Reduction Request MP – 3 Lakewood Anesthesia C/O EZ MED GROUP | |
Reduction Request MP – 4 Uptown Radiology Associates | |
Reduction Request MP – 5 Epic Pain & Orthopedics | |
Reduction Request MP – 6 Preferred Imaging | |
Reduction Request MP – 7 Code 3 ER & Urgent care at Mesquite | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Dale Fields
4 - Litigation
Demand Sent.
Case Status
LOP FORM
LOP MP – 1 Accident Care and Treatment Center of TX, P.A. | |
LOP MP – 2 Champions Rehabilitation | |
LOP MP – 3 PeopleFirst Pharmacy | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Farmers Insurance | |
LOR 3rd Party – 1 Allstate Insurance | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Accident Care and Treatment Center of TX, P.A. | |
Request For Medical Records and Affidavit MP - 2 Champions Rehabilitation | |
Request For Medical Records and Affidavit MP - 3 PeopleFirst Pharmacy | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Accident Care and Treatment Center of TX, P.A. | |
Reduction Request MP – 2 Champions Rehabilitation | |
Reduction Request MP – 3 PeopleFirst Pharmacy | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
- No PIP Coverage
Delailah Chaparro
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 First Class Medical Clinics-Gateway Medical&Pain | |
LOP MP – 2 Southwest X-ray Downtown (No Records) | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 First Class Medical Clinics-Gateway Medical&Pain | |
Request For Medical Records and Affidavit MP - 2 Southwest X-ray Downtown (No Records) | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 First Class Medical Clinics-Gateway Medical&Pain | |
Reduction Request MP – 2 Southwest X-ray Downtown (No Records) | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Denise Keller
Case Status
LOP FORM
LOP MP – 1 | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Erlene Mundy
4 - Litigation
Demand Sent
Case Status
LOP FORM
LOP MP – 1 Revive My Spine | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Farmers | |
LOR 3rd Party – 1 Diamond Specialty | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Revive My Spine | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Revive My Spine | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Eromosele Borha
5 - Discovery
Case Status
LOP FORM
LOP MP – 1 Texas Health Plano Emergency | |
LOP MP – 2 Vivis Inc. dba ReMed | |
LOP MP – 3 Integrative Pain Management Center, PLLC | |
LOP MP – 4 Dallas MRI Center, LLC | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party State Farm Mutual Automobile Insurance Company | lor sent | lor received
LOR 3rd Party – 1 GEICO County Mutual Insurance Company | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 5 - Discovery
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Texas Health Plano Emergency | |
Request For Medical Records and Affidavit MP - 2 Vivis Inc. dba ReMed | |
Request For Medical Records and Affidavit MP - 3 Integrative Pain Management Center, PLLC | |
Request For Medical Records and Affidavit MP - 4 Dallas MRI Center, LLC | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Texas Health Plano Emergency | |
Reduction Request MP – 2 Vivis Inc. dba ReMed | |
Reduction Request MP – 3 Integrative Pain Management Center, PLLC | |
Reduction Request MP – 4 Dallas MRI Center, LLC | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Esmeralda Rodriguez Francisco's Daughter
5 - Discovery
Case Status
LOP FORM
LOP MP – 1 Med Post Urgent Care Rockwall | |
LOP MP – 2 Baylor Scott&White Lake Pointe | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 5 - Discovery
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Med Post Urgent Care Rockwall | |
Request For Medical Records and Affidavit MP - 2 Baylor Scott&White Lake Pointe | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Med Post Urgent Care Rockwall | |
Reduction Request MP – 2 Baylor Scott&White Lake Pointe | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Freida Rivera Coronel
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Baylor Scott&White | |
LOP MP – 2 Southwest Injury Center Inc. | |
LOP MP – 3 Epic Pain & Orthopedics | |
LOP MP – 4 MRI Centers of Texas | |
LOP MP – 5 Data mgnt | |
LOP MP – 6 Mira Vista Apothecary | |
LOP MP – 7 Dallas Radiology, P.A. | |
LOP MP – 8 Lakewood Anesthesia | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party United Automobile Insurance Company | |
LOR 3rd Party – 1 Progressive County Mutual Insurance Company | |
LOR 3rd Party – 2 Texas Farm Bureau Insurance | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Baylor Scott&White | |
Request For Medical Records and Affidavit MP - 2 Southwest Injury Center Inc. | | medical record provider received
Request For Medical Records and Affidavit MP - 3 Epic Pain & Orthopedics | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 4 MRI Centers of Texas | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 5 Data mgnt | |
Request For Medical Records and Affidavit MP - 6 Mira Vista Apothecary | |
Request For Medical Records and Affidavit MP - 7 Dallas Radiology, P.A. | | medical record provider received
Request For Medical Records and Affidavit MP - 8 Lakewood Anesthesia | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Baylor Scott&White | |
Reduction Request MP – 2 Southwest Injury Center Inc. | |
Reduction Request MP – 3 Epic Pain & Orthopedics | |
Reduction Request MP – 4 MRI Centers of Texas | |
Reduction Request MP – 5 Data mgnt | |
Reduction Request MP – 6 Mira Vista Apothecary | |
Reduction Request MP – 7 Dallas Radiology, P.A. | |
Reduction Request MP – 8 Lakewood Anesthesia | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Gabrielle Ford
3 - Demand Pending
Case Status
LOP FORM
LOP MP – 1 Cornerstone Chiropractic | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Allstate | |
LOR 3rd Party – 1 Liberty Mutual | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 3 - Demand Pending
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Cornerstone Chiropractic | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Cornerstone Chiropractic | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Georges P. Nagassa
1 - Medical Treatment and Recovery
Case Status
LOP FORM
LOP MP – 1 | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 Progressive Insurance Company | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 1 - Medical Treatment and Recovery
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Georgianna Wanjiru
4 - Litigation
3rd Party accepted 100% liability.
Case Status
LOP FORM
LOP MP – 1 Southwest injury Center | |
LOP MP – 2 Epic Pain and Orthopedics | |
LOP MP – 3 Walmart Pharmacy | |
LOP MP – 4 DFW MRI | lop provider sent |
LOP MP – 5 Pro Med, Inc. | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 Progressive County Mutual Insurance Company | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Southwest injury Center | |
Request For Medical Records and Affidavit MP - 2 Epic Pain and Orthopedics | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 3 Walmart Pharmacy | |
Request For Medical Records and Affidavit MP - 4 DFW MRI | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 5 Pro Med, Inc. | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Southwest injury Center | |
Reduction Request MP – 2 Epic Pain and Orthopedics | |
Reduction Request MP – 3 Walmart Pharmacy | |
Reduction Request MP – 4 DFW MRI | |
Reduction Request MP – 5 Pro Med, Inc. | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Gordon R. Ellis
Case Status
LOP FORM
LOP MP – 1 MDN Injury Clinic | |
LOP MP – 2 Accident Centers of Texas | |
LOP MP – 3 PeopleFirst Pharmacy | |
LOP MP – 4 MRI Centers of Texas | |
LOP MP – 5 North Texas X-ray | |
LOP MP – 6 Momentum Spine & Joint | |
LOP MP – 7 Uptown Radiology | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party State Farm Mutual Automobile Insurance Company | |
LOR 3rd Party – 1 Progressive County Mutual Ins. Co | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 MDN Injury Clinic | |
Request For Medical Records and Affidavit MP - 2 Accident Centers of Texas | |
Request For Medical Records and Affidavit MP - 3 PeopleFirst Pharmacy | |
Request For Medical Records and Affidavit MP - 4 MRI Centers of Texas | |
Request For Medical Records and Affidavit MP - 5 North Texas X-ray | |
Request For Medical Records and Affidavit MP - 6 Momentum Spine & Joint | |
Request For Medical Records and Affidavit MP - 7 Uptown Radiology | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 MDN Injury Clinic | |
Reduction Request MP – 2 Accident Centers of Texas | |
Reduction Request MP – 3 PeopleFirst Pharmacy | |
Reduction Request MP – 4 MRI Centers of Texas | |
Reduction Request MP – 5 North Texas X-ray | |
Reduction Request MP – 6 Momentum Spine & Joint | |
Reduction Request MP – 7 Uptown Radiology | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
- PIP Coverage
Hayden Adams
4 - Litigation
Demand Sent.
Case Status
LOP FORM
LOP MP – 1 Baylor Scott & White Mc Kinney | |
LOP MP – 2 Accident Centers of Texas | lop provider sent | lop provider received
LOP MP – 3 MRI Centers of Texas | lop provider sent | lop provider received
LOP MP – 4 Data Managment DMC Medical Billing | |
LOP MP – 5 People First Pharmacy | lop provider sent | lop provider received
LOP MP – 6 Infinity Care Medical Group | lop provider sent | lop provider received
LOP MP – 7 Momentum Spine and Joint | lop provider sent | lop provider received
LOP MP – 8 Memorial Care Pharmacy | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 Farmers Insurance- National Document Center | lor sent |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 No Ins/Danise Ins | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Baylor Scott & White Mc Kinney | medical record provider requested |
Request For Medical Records and Affidavit MP - 2 Accident Centers of Texas | | medical record provider received
Request For Medical Records and Affidavit MP - 3 MRI Centers of Texas | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 4 Data Managment DMC Medical Billing | |
Request For Medical Records and Affidavit MP - 5 People First Pharmacy | medical record provider requested |
Request For Medical Records and Affidavit MP - 6 Infinity Care Medical Group | medical record provider requested |
Request For Medical Records and Affidavit MP - 7 Momentum Spine and Joint | |
Request For Medical Records and Affidavit MP - 8 Memorial Care Pharmacy | | medical record provider received
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Baylor Scott & White Mc Kinney | |
Reduction Request MP – 2 Accident Centers of Texas | |
Reduction Request MP – 3 MRI Centers of Texas | |
Reduction Request MP – 4 Data Managment DMC Medical Billing | |
Reduction Request MP – 5 People First Pharmacy | |
Reduction Request MP – 6 Infinity Care Medical Group | |
Reduction Request MP – 7 Momentum Spine and Joint | |
Reduction Request MP – 8 Memorial Care Pharmacy | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Hien Nguyen
Case Status
LOP FORM
LOP MP – 1 Allen Pain & Injury | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party USAA | |
LOR 3rd Party – 1 USAA General Indemnity Company | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Allen Pain & Injury | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Allen Pain & Injury | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Hiramer J Jacobs
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Dr.Ventakta S Chilakapati, MD | |
LOP MP – 2 Wilbarger General Hospital | |
LOP MP – 3 United Regional Healthcare Hospital | |
LOP MP – 4 PAM Rehabilitation Hospital Allen | |
LOP MP – 5 Belmont At Twin Creeks | |
LOP MP – 6 McKinney Medical Center | |
LOP MP – 7 MckinneyCare Pharmacy | |
LOP MP – 8 Complete Heart Care, P.A. | |
LOP MP – 9 AMADA Senior Care Services DONE | |
LOP MP – 10 Albertsons Pharmacy | |
LOR FORM
LOR 1st Party Blue Cross Blue Shield | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Dr.Ventakta S Chilakapati, MD | |
Request For Medical Records and Affidavit MP - 2 Wilbarger General Hospital | |
Request For Medical Records and Affidavit MP - 3 United Regional Healthcare Hospital | |
Request For Medical Records and Affidavit MP - 4 PAM Rehabilitation Hospital Allen | |
Request For Medical Records and Affidavit MP - 5 Belmont At Twin Creeks | |
Request For Medical Records and Affidavit MP - 6 McKinney Medical Center | |
Request For Medical Records and Affidavit MP - 7 MckinneyCare Pharmacy | |
Request For Medical Records and Affidavit MP - 8 Complete Heart Care, P.A. | |
Request For Medical Records and Affidavit MP - 9 AMADA Senior Care Services DONE | |
Request For Medical Records and Affidavit MP - 10 Albertsons Pharmacy | |
Reduction Request Form
Reduction Request MP – 1 Dr.Ventakta S Chilakapati, MD | |
Reduction Request MP – 2 Wilbarger General Hospital | |
Reduction Request MP – 3 United Regional Healthcare Hospital | |
Reduction Request MP – 4 PAM Rehabilitation Hospital Allen | |
Reduction Request MP – 5 Belmont At Twin Creeks | |
Reduction Request MP – 6 McKinney Medical Center | |
Reduction Request MP – 7 MckinneyCare Pharmacy | |
Reduction Request MP – 8 Complete Heart Care, P.A. | |
Reduction Request MP – 9 AMADA Senior Care Services DONE | |
Reduction Request MP – 10 Albertsons Pharmacy | |
12 – Offer for Settlement – Insurance
Hoan Huynh
Case Status
LOP FORM
LOP MP – 1 | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 H-Mart | |
LOR 3rd Party – 2 KC Distributor's | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Ikenna Chris Onunkwo
4 - Litigation
3rd Party accepted 100% liability. Demand Sent
Case Status
LOP FORM
LOP MP – 1 Southwest Injury Center | |
LOP MP – 2 Epic Pain and Orthopedics | lop provider sent | lop provider received
LOP MP – 3 Prime Diagnostic Imaging | | lop provider received
LOP MP – 4 PeopleFirst Pharmacy | |
LOP MP – 5 Pro Med Inc. | |
LOP MP – 6 Elite Anesthesia in care of EZ Med Group | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Commonwealth Insurance Company | |
LOR 3rd Party – 1 State Farm Claims | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Southwest Injury Center | |
Request For Medical Records and Affidavit MP - 2 Epic Pain and Orthopedics | |
Request For Medical Records and Affidavit MP - 3 Prime Diagnostic Imaging | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 4 PeopleFirst Pharmacy | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 5 Pro Med Inc. | |
Request For Medical Records and Affidavit MP - 6 Elite Anesthesia in care of EZ Med Group | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Southwest Injury Center | |
Reduction Request MP – 2 Epic Pain and Orthopedics | |
Reduction Request MP – 3 Prime Diagnostic Imaging | |
Reduction Request MP – 4 PeopleFirst Pharmacy | |
Reduction Request MP – 5 Pro Med Inc. | |
Reduction Request MP – 6 Elite Anesthesia in care of EZ Med Group | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
James Linzer
Third Party has 30/60 Policy
Case Status
LOP FORM
LOP MP – 1 Breeze MRI | |
LOP MP – 2 FB Surgical Associates | |
LOP MP – 3 Ache Institute of Houston | |
LOP MP – 4 Purim Chiropractic | |
LOP MP – 5 People First Pharmacy | |
LOP MP – 6 Houston Methodist Sugar Land Hospital | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Quality Distribution Inc. | |
LOR 3rd Party – 1 Progressive County Mutual Insurance | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 Acord not an ins company | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Breeze MRI | |
Request For Medical Records and Affidavit MP - 2 FB Surgical Associates | | medical record provider received
Request For Medical Records and Affidavit MP - 3 Ache Institute of Houston | |
Request For Medical Records and Affidavit MP - 4 Purim Chiropractic | |
Request For Medical Records and Affidavit MP - 5 People First Pharmacy | |
Request For Medical Records and Affidavit MP - 6 Houston Methodist Sugar Land Hospital | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Breeze MRI | |
Reduction Request MP – 2 FB Surgical Associates | |
Reduction Request MP – 3 Ache Institute of Houston | |
Reduction Request MP – 4 Purim Chiropractic | |
Reduction Request MP – 5 People First Pharmacy | |
Reduction Request MP – 6 Houston Methodist Sugar Land Hospital | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
- No PIP Coverage
James Stroud
1 - Medical Treatment and Recovery
Case Status
LOP FORM
LOP MP – 1 Baylor Scott&White | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 1 - Medical Treatment and Recovery
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Baylor Scott&White | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Baylor Scott&White | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Jessica Pagan
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Accident Centers of Texas | |
LOP MP – 2 MRI Centers of Texas | |
LOP MP – 3 Data Management | |
LOP MP – 4 PeopleFirst Pharmacy | |
LOP MP – 5 Infinity Care Medical Group | |
LOP MP – 6 Methodist Hospital | |
LOP MP – 7 Momentum Spine and Joint | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party ACCC | |
LOR 3rd Party – 1 Allstate | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Accident Centers of Texas | |
Request For Medical Records and Affidavit MP - 2 MRI Centers of Texas | |
Request For Medical Records and Affidavit MP - 3 Data Management | |
Request For Medical Records and Affidavit MP - 4 PeopleFirst Pharmacy | |
Request For Medical Records and Affidavit MP - 5 Infinity Care Medical Group | |
Request For Medical Records and Affidavit MP - 6 Methodist Hospital | |
Request For Medical Records and Affidavit MP - 7 Momentum Spine and Joint | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Accident Centers of Texas | |
Reduction Request MP – 2 MRI Centers of Texas | |
Reduction Request MP – 3 Data Management | |
Reduction Request MP – 4 PeopleFirst Pharmacy | |
Reduction Request MP – 5 Infinity Care Medical Group | |
Reduction Request MP – 6 Methodist Hospital | |
Reduction Request MP – 7 Momentum Spine and Joint | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Jesus Perez
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Accident Centers of Texas | |
LOP MP – 2 MRI Centers of Texas | |
LOP MP – 3 Data Management | |
LOP MP – 4 Infinity Care Medical Group | |
LOP MP – 5 PeopleFirst Pharmacy | |
LOP MP – 6 Methodist Hospital | |
LOP MP – 7 Momentum Spine and Joint | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party ACCC | |
LOR 3rd Party – 1 Allstate Insurance Company | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Accident Centers of Texas | |
Request For Medical Records and Affidavit MP - 2 MRI Centers of Texas | |
Request For Medical Records and Affidavit MP - 3 Data Management | |
Request For Medical Records and Affidavit MP - 4 Infinity Care Medical Group | |
Request For Medical Records and Affidavit MP - 5 PeopleFirst Pharmacy | |
Request For Medical Records and Affidavit MP - 6 Methodist Hospital | |
Request For Medical Records and Affidavit MP - 7 Momentum Spine and Joint | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Accident Centers of Texas | |
Reduction Request MP – 2 MRI Centers of Texas | |
Reduction Request MP – 3 Data Management | |
Reduction Request MP – 4 Infinity Care Medical Group | |
Reduction Request MP – 5 PeopleFirst Pharmacy | |
Reduction Request MP – 6 Methodist Hospital | |
Reduction Request MP – 7 Momentum Spine and Joint | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Joel Lopez
4 - Litigation
Demand Sent.
Case Status
LOP FORM
LOP MP – 1 PeopleFirst Pharmacy | |
LOP MP – 2 Gateway Medical and Pain Center | |
LOP MP – 3 Southwest X-Ray | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Statefarm | |
LOR 3rd Party – 1 Loya Insurance Company | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 PeopleFirst Pharmacy | |
Request For Medical Records and Affidavit MP - 2 Gateway Medical and Pain Center | |
Request For Medical Records and Affidavit MP - 3 Southwest X-Ray | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 PeopleFirst Pharmacy | |
Reduction Request MP – 2 Gateway Medical and Pain Center | |
Reduction Request MP – 3 Southwest X-Ray | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
John Calloway (III) 11/22/2019
Case Status
LOP FORM
LOP MP – 1 Cornerstone Chiropractic | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | lop provider sent | lop provider received
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party USAA | lor sent |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Cornerstone Chiropractic | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | medical record provider requested |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Cornerstone Chiropractic | reduction request sent | reduction request received
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
John Calloway III
Case Status
LOP FORM
LOP MP – 1 Cornerstone Chiropractic | |
LOP MP – 2 5- Park Ambulatory Surgery Center | |
LOP MP – 3 Texas Anesthesia Group, PLLC | |
LOP MP – 4 Texas Pain Relief Group | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party USAA | |
LOR 3rd Party – 1 GEICO County Mutual Insurance Company | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Cornerstone Chiropractic | |
Request For Medical Records and Affidavit MP - 2 5- Park Ambulatory Surgery Center | |
Request For Medical Records and Affidavit MP - 3 Texas Anesthesia Group, PLLC | |
Request For Medical Records and Affidavit MP - 4 Texas Pain Relief Group | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Cornerstone Chiropractic | |
Reduction Request MP – 2 5- Park Ambulatory Surgery Center | |
Reduction Request MP – 3 Texas Anesthesia Group, PLLC | |
Reduction Request MP – 4 Texas Pain Relief Group | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Jorge Gutierrez II
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 PeopleFirst Pharmacy | |
LOP MP – 2 Gateway Medical and Pain Center | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party State Farm Insurance Company | |
LOR 3rd Party – 1 Loya Insurance Company | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 PeopleFirst Pharmacy | |
Request For Medical Records and Affidavit MP - 2 Gateway Medical and Pain Center | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 PeopleFirst Pharmacy | |
Reduction Request MP – 2 Gateway Medical and Pain Center | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Jose Hernandez
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Methodist Dallas Medical Center | |
LOP MP – 2 Elite Healthcare South Dallas Clinic | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 Gainsco, Inc. (DENIED COVERAGE FOR DEFENDANT) | |
LOR 3rd Party – 2 Falcon Ins. | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Methodist Dallas Medical Center | |
Request For Medical Records and Affidavit MP - 2 Elite Healthcare South Dallas Clinic | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Methodist Dallas Medical Center | |
Reduction Request MP – 2 Elite Healthcare South Dallas Clinic | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Joshua Holden
4 - Litigation
Demand Sent
Case Status
LOP FORM
LOP MP – 1 Southwest Injury Center | |
LOP MP – 2 Epic Pain & Orthopedics- Dallas | |
LOP MP – 3 Mira Vista Pharmacy | |
LOP MP – 4 Prime Diagnostic Imaging | lop provider sent | lop provider received
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Nationwide Mutual Insurance Company | |
LOR 3rd Party – 1 Nationwide Mutual Insurance Company | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Southwest Injury Center | |
Request For Medical Records and Affidavit MP - 2 Epic Pain & Orthopedics- Dallas | |
Request For Medical Records and Affidavit MP - 3 Mira Vista Pharmacy | |
Request For Medical Records and Affidavit MP - 4 Prime Diagnostic Imaging | | medical record provider received
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Southwest Injury Center | |
Reduction Request MP – 2 Epic Pain & Orthopedics- Dallas | |
Reduction Request MP – 3 Mira Vista Pharmacy | |
Reduction Request MP – 4 Prime Diagnostic Imaging | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Katherine Mims McDaniel
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Texas Health Harris Methodist Hospital Southwest Ft Worth | |
LOP MP – 2 Progressive Integrated Healthcare | |
LOP MP – 3 DFW pain injury Centers- Burleson Pain and Injury Center (DONE) | |
LOP MP – 4 Mira Vista Apothecary (DONE) | |
LOP MP – 5 Dalla Radiology, PA (DONE) | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 ACCC | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Texas Health Harris Methodist Hospital Southwest Ft Worth | |
Request For Medical Records and Affidavit MP - 2 Progressive Integrated Healthcare | |
Request For Medical Records and Affidavit MP - 3 DFW pain injury Centers- Burleson Pain and Injury Center (DONE) | |
Request For Medical Records and Affidavit MP - 4 Mira Vista Apothecary (DONE) | |
Request For Medical Records and Affidavit MP - 5 Dalla Radiology, PA (DONE) | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Texas Health Harris Methodist Hospital Southwest Ft Worth | |
Reduction Request MP – 2 Progressive Integrated Healthcare | |
Reduction Request MP – 3 DFW pain injury Centers- Burleson Pain and Injury Center (DONE) | |
Reduction Request MP – 4 Mira Vista Apothecary (DONE) | |
Reduction Request MP – 5 Dalla Radiology, PA (DONE) | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Katrina Cartwright
1 - Medical Treatment and Recovery
Case Status
LOP FORM
LOP MP – 1 Purim Chiropractic | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 1 - Medical Treatment and Recovery
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Purim Chiropractic | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Purim Chiropractic | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Kenyan Mims
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Texas Health Harris Methodist Hospital Southwest Ft Worth | |
LOP MP – 2 Progressive Integrated Healthcare | |
LOP MP – 3 DFW Pain & Injury Centers | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 ACCC | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Texas Health Harris Methodist Hospital Southwest Ft Worth | |
Request For Medical Records and Affidavit MP - 2 Progressive Integrated Healthcare | |
Request For Medical Records and Affidavit MP - 3 DFW Pain & Injury Centers | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Texas Health Harris Methodist Hospital Southwest Ft Worth | |
Reduction Request MP – 2 Progressive Integrated Healthcare | |
Reduction Request MP – 3 DFW Pain & Injury Centers | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Kiriath Lumpkin
1 - Medical Treatment and Recovery
Case Status
LOP FORM
LOP MP – 1 | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 1 - Medical Treatment and Recovery
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Kyna Wiltz
Case Status
LOP FORM
LOP MP – 1 Cornerstone Chiropratic | |
LOP MP – 2 ASP Cares | |
LOP MP – 3 DFW Open MRI | |
LOP MP – 4 MDN, P.A. | |
LOP MP – 5 Pro Med, Inc. | |
LOP MP – 6 Richardson/Garland Injury Rehab | |
LOP MP – 7 Village Physical Therapy | |
LOP MP – 8 Up & Open Imaging | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Progressive County Mutual Ins Co | |
LOR 3rd Party – 1 Progressive County Mutual Ins. Co. | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Cornerstone Chiropratic | |
Request For Medical Records and Affidavit MP - 2 ASP Cares | |
Request For Medical Records and Affidavit MP - 3 DFW Open MRI | |
Request For Medical Records and Affidavit MP - 4 MDN, P.A. | |
Request For Medical Records and Affidavit MP - 5 Pro Med, Inc. | |
Request For Medical Records and Affidavit MP - 6 Richardson/Garland Injury Rehab | |
Request For Medical Records and Affidavit MP - 7 Village Physical Therapy | |
Request For Medical Records and Affidavit MP - 8 Up & Open Imaging | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Cornerstone Chiropratic | |
Reduction Request MP – 2 ASP Cares | |
Reduction Request MP – 3 DFW Open MRI | |
Reduction Request MP – 4 MDN, P.A. | |
Reduction Request MP – 5 Pro Med, Inc. | |
Reduction Request MP – 6 Richardson/Garland Injury Rehab | |
Reduction Request MP – 7 Village Physical Therapy | |
Reduction Request MP – 8 Up & Open Imaging | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Laureen Abbo Nono
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Lemnyuy Nyuykongi
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Revive My Spine | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Geigo | |
LOR 3rd Party – 1 State Farm Claims | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Revive My Spine | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Revive My Spine | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Levi Young
Case Status
LOP FORM
LOP MP – 1 PeopleFirst Pharmacy | lop provider sent |
LOP MP – 2 Baylor Scott & White Medical Center | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 PeopleFirst Pharmacy | |
Request For Medical Records and Affidavit MP - 2 Baylor Scott & White Medical Center | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 PeopleFirst Pharmacy | |
Reduction Request MP – 2 Baylor Scott & White Medical Center | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Lister Ziemi
Case Status
LOP FORM
LOP MP – 1 Accident Centers of Texas | |
LOP MP – 2 North Texas X-Ray Service Inc. | |
LOP MP – 3 PeopleFirst Pharmacy | |
LOP MP – 4 MRI Centers of Texas and Data Management | |
LOP MP – 5 Infinity Care Medical Group | |
LOP MP – 6 Momentum Spine and Joint (DIDN'T WENT) | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 Hertz Self Insurance | |
LOR 3rd Party – 2 State Farm Claims | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Accident Centers of Texas | |
Request For Medical Records and Affidavit MP - 2 North Texas X-Ray Service Inc. | |
Request For Medical Records and Affidavit MP - 3 PeopleFirst Pharmacy | |
Request For Medical Records and Affidavit MP - 4 MRI Centers of Texas and Data Management | |
Request For Medical Records and Affidavit MP - 5 Infinity Care Medical Group | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 6 Momentum Spine and Joint (DIDN'T WENT) | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Accident Centers of Texas | |
Reduction Request MP – 2 North Texas X-Ray Service Inc. | |
Reduction Request MP – 3 PeopleFirst Pharmacy | |
Reduction Request MP – 4 MRI Centers of Texas and Data Management | |
Reduction Request MP – 5 Infinity Care Medical Group | |
Reduction Request MP – 6 Momentum Spine and Joint (DIDN'T WENT) | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Macailyn wilder
Case Status
LOP FORM
LOP MP – 1 | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Maria R Ugarte
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 DMC Healthcare | |
LOP MP – 2 Prime Diagnostic Imaging | |
LOP MP – 3 Momentum Spine and Joint | |
LOP MP – 4 North Texas Radiology Consultants | |
LOP MP – 5 JTP Diagnositcs (Prime Imaging is same) | |
LOP MP – 6 Dr. Asad Kahn | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 National General Insurance | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 DMC Healthcare | |
Request For Medical Records and Affidavit MP - 2 Prime Diagnostic Imaging | |
Request For Medical Records and Affidavit MP - 3 Momentum Spine and Joint | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 4 North Texas Radiology Consultants | |
Request For Medical Records and Affidavit MP - 5 JTP Diagnositcs (Prime Imaging is same) | |
Request For Medical Records and Affidavit MP - 6 Dr. Asad Kahn | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 DMC Healthcare | |
Reduction Request MP – 2 Prime Diagnostic Imaging | |
Reduction Request MP – 3 Momentum Spine and Joint | |
Reduction Request MP – 4 North Texas Radiology Consultants | |
Reduction Request MP – 5 JTP Diagnositcs (Prime Imaging is same) | |
Reduction Request MP – 6 Dr. Asad Kahn | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Marie Bell-Rosemond
4 - Litigation
Case Status
LOP FORM
LOP MP – 1 Texas Health Harris Methodist Hospital | |
LOP MP – 2 Accident Centers of Texas | |
LOP MP – 3 PeopleFirst Pharmacy | |
LOP MP – 4 Vertex Pain & Orthopedic (bill) | |
LOP MP – 5 MDN (8/10/19 ONE VISIT MISSING AND 6/27/2019 ONE VISIT MISSING) | |
LOP MP – 6 Uptown Radiology Associates (bill) P9/Radiology Associates of North TX p9 | |
LOP MP – 7 MRI Centers of Texas (done) | |
LOP MP – 8 Medstar Mobile Healthcare BILL | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 Sedgwick | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Texas Health Harris Methodist Hospital | |
Request For Medical Records and Affidavit MP - 2 Accident Centers of Texas | |
Request For Medical Records and Affidavit MP - 3 PeopleFirst Pharmacy | |
Request For Medical Records and Affidavit MP - 4 Vertex Pain & Orthopedic (bill) | |
Request For Medical Records and Affidavit MP - 5 MDN (8/10/19 ONE VISIT MISSING AND 6/27/2019 ONE VISIT MISSING) | |
Request For Medical Records and Affidavit MP - 6 Uptown Radiology Associates (bill) P9/Radiology Associates of North TX p9 | |
Request For Medical Records and Affidavit MP - 7 MRI Centers of Texas (done) | |
Request For Medical Records and Affidavit MP - 8 Medstar Mobile Healthcare BILL | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Texas Health Harris Methodist Hospital | |
Reduction Request MP – 2 Accident Centers of Texas | |
Reduction Request MP – 3 PeopleFirst Pharmacy | |
Reduction Request MP – 4 Vertex Pain & Orthopedic (bill) | |
Reduction Request MP – 5 MDN (8/10/19 ONE VISIT MISSING AND 6/27/2019 ONE VISIT MISSING) | |
Reduction Request MP – 6 Uptown Radiology Associates (bill) P9/Radiology Associates of North TX p9 | |
Reduction Request MP – 7 MRI Centers of Texas (done) | |
Reduction Request MP – 8 Medstar Mobile Healthcare BILL | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Marie Bell-Rosemond
Case Status
LOP FORM
LOP MP – 1 Texas Health Harris Methodist Hospital | |
LOP MP – 2 Accident Centers of Texas | |
LOP MP – 3 MRI Centers of Texas | |
LOP MP – 4 Vertex Interventional Physicians | |
LOP MP – 5 MDN Injury Care | |
LOP MP – 6 People First Pharmacy | |
LOP MP – 7 Radiology Associates of North America | |
LOP MP – 8 Med Star Mobile Healthcare | |
LOP MP – 9 Uptown Radiology Associates | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 Sedwick | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Texas Health Harris Methodist Hospital | | medical record provider received
Request For Medical Records and Affidavit MP - 2 Accident Centers of Texas | | medical record provider received
Request For Medical Records and Affidavit MP - 3 MRI Centers of Texas | | medical record provider received
Request For Medical Records and Affidavit MP - 4 Vertex Interventional Physicians | | medical record provider received
Request For Medical Records and Affidavit MP - 5 MDN Injury Care | | medical record provider received
Request For Medical Records and Affidavit MP - 6 People First Pharmacy | | medical record provider received
Request For Medical Records and Affidavit MP - 7 Radiology Associates of North America | | medical record provider received
Request For Medical Records and Affidavit MP - 8 Med Star Mobile Healthcare | | medical record provider received
Request For Medical Records and Affidavit MP - 9 Uptown Radiology Associates | | medical record provider received
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Texas Health Harris Methodist Hospital | |
Reduction Request MP – 2 Accident Centers of Texas | |
Reduction Request MP – 3 MRI Centers of Texas | |
Reduction Request MP – 4 Vertex Interventional Physicians | |
Reduction Request MP – 5 MDN Injury Care | |
Reduction Request MP – 6 People First Pharmacy | |
Reduction Request MP – 7 Radiology Associates of North America | |
Reduction Request MP – 8 Med Star Mobile Healthcare | |
Reduction Request MP – 9 Uptown Radiology Associates | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Mario Nguyen
Case Status
LOP FORM
LOP MP – 1 Allen Pain & Injury | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party USAA | |
LOR 3rd Party – 1 USAA Claims Department | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Allen Pain & Injury | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Allen Pain & Injury | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Melissa Fields
4 - Litigation
Demand Sent
Case Status
LOP FORM
LOP MP – 1 Accident Care and Treatment Center of TX, P.A. | |
LOP MP – 2 Champions Rehabilitation | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 Allstate Insurance | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Accident Care and Treatment Center of TX, P.A. | |
Request For Medical Records and Affidavit MP - 2 Champions Rehabilitation | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Accident Care and Treatment Center of TX, P.A. | |
Reduction Request MP – 2 Champions Rehabilitation | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
- No PIP Coverage
Melissa Rodriguez Francisco's Daughter
Case Status
LOP FORM
LOP MP – 1 Med Post Urgent Care Rockwall | |
LOP MP – 2 Baylor Scott&White Lake Pointe | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Med Post Urgent Care Rockwall | |
Request For Medical Records and Affidavit MP - 2 Baylor Scott&White Lake Pointe | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Med Post Urgent Care Rockwall | |
Reduction Request MP – 2 Baylor Scott&White Lake Pointe | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Michael W. Langford
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Legacy ER & Urgent Care | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Legacy ER & Urgent Care | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Legacy ER & Urgent Care | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Miguel Sanchez
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Element Health & Wellness – Dallas | |
LOP MP – 2 MRI Centers of Texas | |
LOP MP – 3 Uptown Radiology | |
LOP MP – 4 Baylor Scott&White | |
LOP MP – 5 Pro Med, Inc. | |
LOP MP – 6 Epic Pain and Orthopedics | |
LOP MP – 7 Evolve Healthcare | |
LOP MP – 8 Dallas Radiology, P.A | |
LOP MP – 9 Frontline ER Whiterock- Emergency Department | |
LOP MP – 10 City of Dallas- BLS emergency / 11. Century Integrated Partners, Inc. | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 State Farms | |
LOR 3rd Party – 2 Progressive | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Element Health & Wellness – Dallas | | medical record provider received
Request For Medical Records and Affidavit MP - 2 MRI Centers of Texas | | medical record provider received
Request For Medical Records and Affidavit MP - 3 Uptown Radiology | |
Request For Medical Records and Affidavit MP - 4 Baylor Scott&White | | medical record provider received
Request For Medical Records and Affidavit MP - 5 Pro Med, Inc. | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 6 Epic Pain and Orthopedics | | medical record provider received
Request For Medical Records and Affidavit MP - 7 Evolve Healthcare | |
Request For Medical Records and Affidavit MP - 8 Dallas Radiology, P.A | |
Request For Medical Records and Affidavit MP - 9 Frontline ER Whiterock- Emergency Department | | medical record provider received
Request For Medical Records and Affidavit MP - 10 City of Dallas- BLS emergency / 11. Century Integrated Partners, Inc. | |
Reduction Request Form
Reduction Request MP – 1 Element Health & Wellness – Dallas | |
Reduction Request MP – 2 MRI Centers of Texas | |
Reduction Request MP – 3 Uptown Radiology | |
Reduction Request MP – 4 Baylor Scott&White | |
Reduction Request MP – 5 Pro Med, Inc. | |
Reduction Request MP – 6 Epic Pain and Orthopedics | |
Reduction Request MP – 7 Evolve Healthcare | |
Reduction Request MP – 8 Dallas Radiology, P.A | |
Reduction Request MP – 9 Frontline ER Whiterock- Emergency Department | |
Reduction Request MP – 10 City of Dallas- BLS emergency / 11. Century Integrated Partners, Inc. | |
12 – Offer for Settlement – Insurance
Mirna Hernandez
4 - Litigation
Demand Sent
Case Status
LOP FORM
LOP MP – 1 Gateway Medical | |
LOP MP – 2 Omni HealthCare ( Omi and Southwest X-ray are same) | |
LOP MP – 3 Southwest X-Ray Downtown | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 Travelers Insurance | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Gateway Medical | |
Request For Medical Records and Affidavit MP - 2 Omni HealthCare ( Omi and Southwest X-ray are same) | |
Request For Medical Records and Affidavit MP - 3 Southwest X-Ray Downtown | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Gateway Medical | |
Reduction Request MP – 2 Omni HealthCare ( Omi and Southwest X-ray are same) | |
Reduction Request MP – 3 Southwest X-Ray Downtown | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Nana Bonsu
4 - Litigation
Demand Sent
Case Status
LOP FORM
LOP MP – 1 Revive Injury and Rehab | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 Falcon insurance | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Revive Injury and Rehab | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Revive Injury and Rehab | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Nancy Rounds
Case Status
LOP FORM
LOP MP – 1 MedPost Urgent Care- McKinney | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 MedPost Urgent Care- McKinney | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 MedPost Urgent Care- McKinney | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Natalie Cline
1 - Medical Treatment and Recovery
Case Status
LOP FORM
LOP MP – 1 Desoto Injury Rehab | lop provider sent | lop provider received
LOP MP – 2 Pain Clarity | lop provider sent | lop provider received
LOP MP – 3 SINA RX Pharmacy | lop provider sent | lop provider received
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 1 - Medical Treatment and Recovery
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Desoto Injury Rehab | |
Request For Medical Records and Affidavit MP - 2 Pain Clarity | |
Request For Medical Records and Affidavit MP - 3 SINA RX Pharmacy | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Desoto Injury Rehab | |
Reduction Request MP – 2 Pain Clarity | |
Reduction Request MP – 3 SINA RX Pharmacy | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Nathaniel K. Craighead
4 - Litigation
3rd Party accepted 100% liability. Demand sent.
Case Status
LOP FORM
LOP MP – 1 PRIME Diagnostic Imaging | |
LOP MP – 2 Epic Pain & Orthopedics | |
LOP MP – 3 Southwest Injury Center, Inc. | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Allstate Insurance Company | |
LOR 3rd Party – 1 USAA- United Services Automobile Assn. | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 PRIME Diagnostic Imaging | |
Request For Medical Records and Affidavit MP - 2 Epic Pain & Orthopedics | |
Request For Medical Records and Affidavit MP - 3 Southwest Injury Center, Inc. | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 PRIME Diagnostic Imaging | reduction request sent |
Reduction Request MP – 2 Epic Pain & Orthopedics | reduction request sent |
Reduction Request MP – 3 Southwest Injury Center, Inc. | reduction request sent |
Reduction Request MP – 4 | reduction request sent |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Nhung Nguyen
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Rockwall Injury Rehab | |
LOP MP – 2 ASP Cares | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Allstate Insurance Company | |
LOR 3rd Party – 1 Farmers Insurance | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Rockwall Injury Rehab | |
Request For Medical Records and Affidavit MP - 2 ASP Cares | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Rockwall Injury Rehab | |
Reduction Request MP – 2 ASP Cares | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Nina Wendy
Case Status
LOP FORM
LOP MP – 1 | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Quinton Ledaris Williams
Case Status
LOP FORM
LOP MP – 1 Pedro Nosnik, M.D., P.A. | |
LOP MP – 2 Richardson Injury Rehab | |
LOP MP – 3 DFW Open MRI Plano | |
LOP MP – 4 Preferred Imaging | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party GEICO Indemnity Company | |
LOR 3rd Party – 1 ACCC Insurance Company | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Pedro Nosnik, M.D., P.A. | |
Request For Medical Records and Affidavit MP - 2 Richardson Injury Rehab | |
Request For Medical Records and Affidavit MP - 3 DFW Open MRI Plano | |
Request For Medical Records and Affidavit MP - 4 Preferred Imaging | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Pedro Nosnik, M.D., P.A. | |
Reduction Request MP – 2 Richardson Injury Rehab | |
Reduction Request MP – 3 DFW Open MRI Plano | |
Reduction Request MP – 4 Preferred Imaging | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Richard Cetrone
Case Status
LOP FORM
LOP MP – 1 | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Old American Indemnity Company | |
LOR 3rd Party – 1 Gieco | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Robert Holt
4 - Litigation
3rd party accepted 100% liability. Demand Sent.
Case Status
LOP FORM
LOP MP – 1 MRI Centers of Texas | |
LOP MP – 2 Cano Health & Rehab Clinics, P.A | |
LOP MP – 3 Epic Pain & ortho | |
LOP MP – 4 Dallas Radiology | |
LOP MP – 5 Medical City las colinas | |
LOP MP – 6 Texas Radiology Associates LLP | |
LOP MP – 7 Lone Star Neurology | lop provider sent |
LOP MP – 8 AMPM Medical Centers | |
LOP MP – 9 Tricity Pain Associates P.A | |
LOP MP – 10 Lakewood Anesthesia in the care of EZ Med Group | |
LOR FORM
LOR 1st Party MGA Insurance Company, Inc. | |
LOR 3rd Party – 1 Metropolitan Group Property and Casualty Insurance Company | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 MRI Centers of Texas | |
Request For Medical Records and Affidavit MP - 2 Cano Health & Rehab Clinics, P.A | |
Request For Medical Records and Affidavit MP - 3 Epic Pain & ortho | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 4 Dallas Radiology | |
Request For Medical Records and Affidavit MP - 5 Medical City las colinas | |
Request For Medical Records and Affidavit MP - 6 Texas Radiology Associates LLP | |
Request For Medical Records and Affidavit MP - 7 Lone Star Neurology | |
Request For Medical Records and Affidavit MP - 8 AMPM Medical Centers | |
Request For Medical Records and Affidavit MP - 9 Tricity Pain Associates P.A | |
Request For Medical Records and Affidavit MP - 10 Lakewood Anesthesia in the care of EZ Med Group | |
Reduction Request Form
Reduction Request MP – 1 MRI Centers of Texas | |
Reduction Request MP – 2 Cano Health & Rehab Clinics, P.A | |
Reduction Request MP – 3 Epic Pain & ortho | |
Reduction Request MP – 4 Dallas Radiology | |
Reduction Request MP – 5 Medical City las colinas | |
Reduction Request MP – 6 Texas Radiology Associates LLP | |
Reduction Request MP – 7 Lone Star Neurology | |
Reduction Request MP – 8 AMPM Medical Centers | |
Reduction Request MP – 9 Tricity Pain Associates P.A | |
Reduction Request MP – 10 Lakewood Anesthesia in the care of EZ Med Group | |
12 – Offer for Settlement – Insurance
Robin LouQueena Stevenson
Case Status
LOP FORM
LOP MP – 1 | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Semaj Hicks
Case Status
LOP FORM
LOP MP – 1 Plano Injury Rehab & Chiropractic | |
LOP MP – 2 Vital Pain Care - Addison | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Fred Loya Insurance | |
LOR 3rd Party – 1 Progressive Insurance | |
LOR 3rd Party – 2 ACCC Insurance Company | |
LOR 3rd Party – 3 Empower Insurance | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Plano Injury Rehab & Chiropractic | |
Request For Medical Records and Affidavit MP - 2 Vital Pain Care - Addison | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Plano Injury Rehab & Chiropractic | |
Reduction Request MP – 2 Vital Pain Care - Addison | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Sonia Lopez
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Dallas Regional Medical Center | |
LOP MP – 2 BSW Orthopedic Associates of Dallas | |
LOP MP – 3 Baylor Scott&White sama as provider 2 | |
LOP MP – 4 Actnow1 (Client did not go to Actnow1) | |
LOP MP – 5 North Texas X-Ray Services, Inc. DONE | |
LOP MP – 6 MDN Injury Care (Client did not go to MDN) | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Dallas Regional Medical Center | |
Request For Medical Records and Affidavit MP - 2 BSW Orthopedic Associates of Dallas | |
Request For Medical Records and Affidavit MP - 3 Baylor Scott&White sama as provider 2 | |
Request For Medical Records and Affidavit MP - 4 Actnow1 (Client did not go to Actnow1) | |
Request For Medical Records and Affidavit MP - 5 North Texas X-Ray Services, Inc. DONE | |
Request For Medical Records and Affidavit MP - 6 MDN Injury Care (Client did not go to MDN) | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Dallas Regional Medical Center | |
Reduction Request MP – 2 BSW Orthopedic Associates of Dallas | |
Reduction Request MP – 3 Baylor Scott&White sama as provider 2 | |
Reduction Request MP – 4 Actnow1 (Client did not go to Actnow1) | |
Reduction Request MP – 5 North Texas X-Ray Services, Inc. DONE | |
Reduction Request MP – 6 MDN Injury Care (Client did not go to MDN) | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Tamara T Fuller (FBO) Deanna Hammett
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 BSW Medical Center- Lake Pointe | |
LOP MP – 2 Revive Injury and Rehab | |
LOP MP – 3 MRI Centers of Texas | |
LOP MP – 4 Data Management Medical Billing | |
LOP MP – 5 Epic Pain& Orthopedics | |
LOP MP – 6 Pro Med, Inc. | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 TXFB-INS | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 BSW Medical Center- Lake Pointe | |
Request For Medical Records and Affidavit MP - 2 Revive Injury and Rehab | |
Request For Medical Records and Affidavit MP - 3 MRI Centers of Texas | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 4 Data Management Medical Billing | |
Request For Medical Records and Affidavit MP - 5 Epic Pain& Orthopedics | |
Request For Medical Records and Affidavit MP - 6 Pro Med, Inc. | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 BSW Medical Center- Lake Pointe | |
Reduction Request MP – 2 Revive Injury and Rehab | |
Reduction Request MP – 3 MRI Centers of Texas | |
Reduction Request MP – 4 Data Management Medical Billing | |
Reduction Request MP – 5 Epic Pain& Orthopedics | |
Reduction Request MP – 6 Pro Med, Inc. | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Tanya Bakari
Case Status
LOP FORM
LOP MP – 1 Chiropractic Healthcare Center (a/k/a Accident Centers of Texas) | lop provider sent | lop provider received
LOP MP – 2 MDN Injury Care | |
LOP MP – 3 PeopleFirst Pharmacy | |
LOP MP – 4 MRI Centers of Texas | lop provider sent | lop provider received
LOP MP – 5 Pro Med Ortho | lop provider sent |
LOP MP – 6 North TX X'ray | |
LOP MP – 7 Vertex Interventional Physicians | |
LOP MP – 8 Accident Centers of Texas ( same as Chiropractic Healthcare) | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Progressive County Mutual Ins. Co | lor sent |
LOR 3rd Party – 1 Elephant Auto Insurance | |
LOR 3rd Party – 2 Amica | lor sent |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Chiropractic Healthcare Center (a/k/a Accident Centers of Texas) | | medical record provider received
Request For Medical Records and Affidavit MP - 2 MDN Injury Care | | medical record provider received
Request For Medical Records and Affidavit MP - 3 PeopleFirst Pharmacy | | medical record provider received
Request For Medical Records and Affidavit MP - 4 MRI Centers of Texas | |
Request For Medical Records and Affidavit MP - 5 Pro Med Ortho | |
Request For Medical Records and Affidavit MP - 6 North TX X'ray | |
Request For Medical Records and Affidavit MP - 7 Vertex Interventional Physicians | |
Request For Medical Records and Affidavit MP - 8 Accident Centers of Texas ( same as Chiropractic Healthcare) | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Chiropractic Healthcare Center (a/k/a Accident Centers of Texas) | |
Reduction Request MP – 2 MDN Injury Care | |
Reduction Request MP – 3 PeopleFirst Pharmacy | |
Reduction Request MP – 4 MRI Centers of Texas | |
Reduction Request MP – 5 Pro Med Ortho | |
Reduction Request MP – 6 North TX X'ray | |
Reduction Request MP – 7 Vertex Interventional Physicians | |
Reduction Request MP – 8 Accident Centers of Texas ( same as Chiropractic Healthcare) | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Tanya Bakari
Case Status
LOP FORM
LOP MP – 1 Vertex Pain & Orthopedic | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Vertex Pain & Orthopedic | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Vertex Pain & Orthopedic | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Teresa Rodriguez Francisco's Wife
Case Status
LOP FORM
LOP MP – 1 Med Post Urgent Care Rockwall | |
LOP MP – 2 Baylor Scott&White Lake Pointe | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 DTW Claims Management | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Med Post Urgent Care Rockwall | |
Request For Medical Records and Affidavit MP - 2 Baylor Scott&White Lake Pointe | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Med Post Urgent Care Rockwall | |
Reduction Request MP – 2 Baylor Scott&White Lake Pointe | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Test Client
Demand Pending
Case Status
LOP FORM
LOP MP – 1 cHIRO JIRO | |
LOP MP – 2 dCOTR 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 Allstate | |
LOR 3rd Party – 2 goVERNMENT INSURANCE 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage Demand Pending
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 cHIRO JIRO | |
Request For Medical Records and Affidavit MP - 2 dCOTR 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 cHIRO JIRO | |
Reduction Request MP – 2 dCOTR 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
- PIP Coverage
Thi Huynh
4 - Litigation
Case Status
LOP FORM
LOP MP – 1 Dallas Multidisciplinary Clinic, P.A. | |
LOP MP – 2 Vital Pain Care | |
LOP MP – 3 JTP Diagnostics - Prime | |
LOP MP – 4 People First Pharmacy | |
LOP MP – 5 Radiology Consultants North Texas | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Geico | |
LOR 3rd Party – 1 State Farm | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Dallas Multidisciplinary Clinic, P.A. | |
Request For Medical Records and Affidavit MP - 2 Vital Pain Care | |
Request For Medical Records and Affidavit MP - 3 JTP Diagnostics - Prime | |
Request For Medical Records and Affidavit MP - 4 People First Pharmacy | |
Request For Medical Records and Affidavit MP - 5 Radiology Consultants North Texas | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Dallas Multidisciplinary Clinic, P.A. | |
Reduction Request MP – 2 Vital Pain Care | |
Reduction Request MP – 3 JTP Diagnostics - Prime | |
Reduction Request MP – 4 People First Pharmacy | |
Reduction Request MP – 5 Radiology Consultants North Texas | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Tiffany Edwards (fbo) Jarany Edwards
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Childrens Medical Center | |
LOP MP – 2 Desoto Injury Rehab | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Progressive | |
LOR 3rd Party – 1 DMA Express Auto - SEAHARBOR INSURANCE AGENCY LLC | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Childrens Medical Center | |
Request For Medical Records and Affidavit MP - 2 Desoto Injury Rehab | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Childrens Medical Center | |
Reduction Request MP – 2 Desoto Injury Rehab | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Tony Fore
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Tracy Calloway
Case Status
LOP FORM
LOP MP – 1 Cornerstone Chiropractic | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party USAA | |
LOR 3rd Party – 1 GEICO County Mutual Insurance Company | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Cornerstone Chiropractic | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Cornerstone Chiropractic | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Tram Nhu-Ngoc Nguyen
Case Status
LOP FORM
LOP MP – 1 Texas Health Presbyterian Hospital Allen | |
LOP MP – 2 Momentum Spine & Joint | |
LOP MP – 3 ASP Cares | |
LOP MP – 4 Pain Clarity LLC | |
LOP MP – 5 Richardson/Garland Injury Rehab | |
LOP MP – 6 DFW Open MRI | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party GEICO | |
LOR 3rd Party – 1 Garrison Property & Casualty Ins, Co. | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Texas Health Presbyterian Hospital Allen | |
Request For Medical Records and Affidavit MP - 2 Momentum Spine & Joint | |
Request For Medical Records and Affidavit MP - 3 ASP Cares | |
Request For Medical Records and Affidavit MP - 4 Pain Clarity LLC | |
Request For Medical Records and Affidavit MP - 5 Richardson/Garland Injury Rehab | |
Request For Medical Records and Affidavit MP - 6 DFW Open MRI | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Texas Health Presbyterian Hospital Allen | |
Reduction Request MP – 2 Momentum Spine & Joint | |
Reduction Request MP – 3 ASP Cares | |
Reduction Request MP – 4 Pain Clarity LLC | |
Reduction Request MP – 5 Richardson/Garland Injury Rehab | |
Reduction Request MP – 6 DFW Open MRI | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Vanessa Rodriguez Francisco's Daughter
Case Status
LOP FORM
LOP MP – 1 Med Post Urgent Care Rockwall | |
LOP MP – 2 Baylor Scott&White Lake Pointe | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party | |
LOR 3rd Party – 1 | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Med Post Urgent Care Rockwall | |
Request For Medical Records and Affidavit MP - 2 Baylor Scott&White Lake Pointe | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Med Post Urgent Care Rockwall | |
Reduction Request MP – 2 Baylor Scott&White Lake Pointe | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Wale Ajiboye
2 - Gathering Medical Records
Case Status
LOP FORM
LOP MP – 1 Revive Injury and Rehab | lop provider sent | lop provider received
LOP MP – 2 DFW open MRI | |
LOP MP – 3 Atlantic Diagnostics/American Imaging | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Allstate | lor sent |
LOR 3rd Party – 1 Hit and Run | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 2 - Gathering Medical Records
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Revive Injury and Rehab | |
Request For Medical Records and Affidavit MP - 2 DFW open MRI | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 3 Atlantic Diagnostics/American Imaging | medical record provider requested | medical record provider received
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Revive Injury and Rehab | |
Reduction Request MP – 2 DFW open MRI | |
Reduction Request MP – 3 Atlantic Diagnostics/American Imaging | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Willie Johnson
Case Status
LOP FORM
LOP MP – 1 Cornerstone Chiropratic | |
LOP MP – 2 | |
LOP MP – 3 | |
LOP MP – 4 | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Esurance | |
LOR 3rd Party – 1 Geico | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Cornerstone Chiropratic | |
Request For Medical Records and Affidavit MP - 2 | |
Request For Medical Records and Affidavit MP - 3 | |
Request For Medical Records and Affidavit MP - 4 | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Cornerstone Chiropratic | |
Reduction Request MP – 2 | |
Reduction Request MP – 3 | |
Reduction Request MP – 4 | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
12 – Offer for Settlement – Insurance
Yen Le
4 - Litigation
Case Status
LOP FORM
LOP MP – 1 Dallas Multidisciplinary Clinic, P.A. | |
LOP MP – 2 Vital Pain Care | |
LOP MP – 3 People First Pharmacy | |
LOP MP – 4 Radiology Consultants-North Texas, PLLC | |
LOP MP – 5 | |
LOP MP – 6 | |
LOP MP – 7 | |
LOP MP – 8 | |
LOP MP – 9 | |
LOP MP – 10 | |
LOR FORM
LOR 1st Party Geico | |
LOR 3rd Party – 1 State Farm | |
LOR 3rd Party – 2 | |
LOR 3rd Party – 3 | |
Demand Letter
Client Case Status FORM
Download 1 – Client Case Status Update Your case is at stage 4 - Litigation
Request For Medical Records and Affidavit
Request For Medical Records and Affidavit MP - 1 Dallas Multidisciplinary Clinic, P.A. | |
Request For Medical Records and Affidavit MP - 2 Vital Pain Care | |
Request For Medical Records and Affidavit MP - 3 People First Pharmacy | |
Request For Medical Records and Affidavit MP - 4 Radiology Consultants-North Texas, PLLC | |
Request For Medical Records and Affidavit MP - 5 | |
Request For Medical Records and Affidavit MP - 6 | |
Request For Medical Records and Affidavit MP - 7 | |
Request For Medical Records and Affidavit MP - 8 | |
Request For Medical Records and Affidavit MP - 9 | |
Request For Medical Records and Affidavit MP - 10 | |
Reduction Request Form
Reduction Request MP – 1 Dallas Multidisciplinary Clinic, P.A. | |
Reduction Request MP – 2 Vital Pain Care | |
Reduction Request MP – 3 People First Pharmacy | |
Reduction Request MP – 4 Radiology Consultants-North Texas, PLLC | |
Reduction Request MP – 5 | |
Reduction Request MP – 6 | |
Reduction Request MP – 7 | |
Reduction Request MP – 8 | |
Reduction Request MP – 9 | |
Reduction Request MP – 10 | |
