Fill Online
 

This page is exclusively for Lawyers, Adjusters, Nurse Case Managers, Case Managers, Paralegals and/or Legal Assistants

Thank you for reaching out to us. In order to process your requests in a timely and efficient way, we have designated an exclusive page just for you with a password-protected feature that will easily allow you to sign in.  From the main menu choose "Worker's Comp Fee Agreement" entered the password that was sent to your email. Carefully review that section before proceeding to complete the agreement form. Once you have completed the form SAVE it and send it to our email along with the FROI (incident report).  If you have any questions please send us an email at info@mindhopeofoviedo.com

PLEASE DO NOT SEND ELECTRONIC MEDICAL RECORDS. ALL MEDICAL RECORDS NEED TO BE MAILED TO OUR OFFICE.  DIGITAL MEDICAL RECORDS WILL BE ACCEPTED ONLY IF THEY ARE 15 OR FEWER PAGES.

                                                                          Thank You

 
Fill Online