Legal Request Form

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 Yes    No      Phone Conference Before Report Finalization?

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Doctor and Specialty *

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Issues or Injuries: *


 Yes    No      Is there a CR 35 stipulation with this case?


 Yes    No      Would you like PDS to coordinate scheduling with Plaintiff’s Counsel?


 Yes    No      Interpreter or Other Special Services Needed?

List of Treating Providers 

Other Info