National Services Office

313-779-9189

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Please provide the following information:

  • Date of Loss

  • Name of Injured Claimant(s)

  • Date of Birth of Injured Claimant(s)

  • Amount of potential settlement to be placed into a Structure

Please provide the following information:

  • Copy of most recent MSA Allocation Report, or

  • Copy of CMS Approval

  • Recent Medicals so we may obtain Rated Ages

Please provide the following information:

  • Copy of Life Care Plan

  • 10-20 pages of recent medicals to obtain rated ages

Please provide the following information:

  • Name and Date of Birth of Injured Client

  • Name and Date of Birth of Requesting Attorney

  • Amount of Attorney Fee to be Structured