Attorney Name (required)
Your Email (required)
Is your case settled?
Amount of Gross Settlement?
Have you reached impasse in your medical lien negotiations?
Amount of Medical Bill/Lien?
Amount paid by PIP, if any?
Amount of Legal Fees?
Amount of Legal Costs?
Amount of other liens against settlement?
Please describe any other important issues/details.
Please submit a copy of your Itemized Medical Bill.
Please Contact Us, but we cannot begin until your case settles.
Please Contact Us, but we cannot begin until your negotiations reach impasse.
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