DISCOVERY FOR THE DIGITAL AGE DISCOVERY FOR THE DIGITAL AGE Client Order Form Order Number Special Order Instructions Ordering Party * Primary Contact * Secondary Contact Contact Email * Contact Phone * Address, City, State, Zip File Number Billing Information (Please Select Billing Party) * Ordering (Above)Carrier (Below) Carrier Adjuster Address, City, State, Zip Phone Claim Number DOL Case Information Please select order type * Signed Release / AuthCivilWCAB Case Name Case Number Court/County Representing Other Counsel Send Copies to Other Counsel? * YesNo Other Counsel Name/Address Claimant Information Name * AKA SSN# Date of Birth Claimant Information Location 1 Meds Bills Films Ins. Emp. Other Name, Address, City, State, Zip, Phone, Special Instructions Location 2 Meds Bills Films Ins. Emp. Other Name, Address, City, State, Zip, Phone, Special Instructions Location 3 Meds Bills Films Ins. Emp. Other Name, Address, City, State, Zip, Phone, Special Instructions Location 4 Meds Bills Films Ins. Emp. Other Name, Address, City, State, Zip, Phone, Special Instructions Location 5 Meds Bills Films Ins. Emp. Other Name, Address, City, State, Zip, Phone, Special Instructions Location 6 Meds Bills Films Ins. Emp. Other Name, Address, City, State, Zip, Phone, Special Instructions SMART CHART Intelligent Records DISCOVER MORE Direct Digital Instantly Share GET ACCESS Cloud Imaging View X-rays Online SEE HOW IT WORKS Jetfile Electronic Filing GET STARTED TODAY SMART CHART Intelligent Records DISCOVER MORE Cloud Imaging View X-rays Online SEE HOW IT WORKS Direct Digital Instantly Share GET ACCESS Jetfile Electronic Filing GET STARTED TODAY STAY IN TOUCH CONTACT US 888-248-0020 | *protected email* Offering Digital Document Retrieval and Service of Process throughout the continental United States. ORDER NOW STAY IN TOUCH CONTACT US 888-248-0020 *protected email* Offering Digital Document Retrieval and Service of Process throughout the continental United States. ORDER NOW
SMART CHART