Patient Intake

Become a Patient

Select the type of case that applies to you. We'll take you to the right intake form.

No Fault

Injured in a car accident? We handle no-fault billing directly so you can focus on recovery.

Work-related injury prescriptions handled with care — we work directly with your employer's insurer.

No insurance? No problem. We accept liens and letters of protection from your attorney.

All forms are available in English and Español. Your information is kept strictly confidential.