Attorney Portal

Submit Your Request

Complete the form below and our team will confirm receipt within one business day.

Firm & Attorney Information

Firm Name *

Attorney or Paralegal Name *

Email Address *

Phone Number

Client & Case Information

Client Name *

Client Date of Birth

Case / File Number

Date of Incident

Matter Type

Healthcare Providers

Add each provider from whom records should be requested. Each provider is billed at $30.

1 Provider Added

Provider 1

Provider / Facility Name *

Phone Number

Address

Records From

Records Through

Record Types Requested

Special InstructionsOptional

Request Priority

Notes for our team

AttachmentsOptional

Upload HIPAA authorizations, agency authorizations, or any supporting documents (PDF, JPG, PNG — max 20 MB each).

Attach Files

*By submitting, you confirm proper HIPAA authorization is on file. **By submitting this request, you represent that you possess the necessary legal authority and authorization to request the records identified herein and have reviewed our Privacy Policy.