top of page

For Personal Injury, Auto Accident, WC and Independent Medical Examination (IME) patients, please fill out our intake form and email it to krodriguez.uoc@gmail.com or fax it to 404-480-4209.

 

Someone will contact you by email to schedule appointments once the form is received and reviewed.

 

Intake Form Instructions

 

Please circle the type of appointment you are requesting. If the patient is being seen through an insurance company, please make sure to include all the adjuster information as well as a claim number and date of injury. If the patient is being seen on a lien, please fill out the Physician LIEN form (link to Physician LIEN PDF) and we will obtain the patient’s signature at the time of the appointment. Please note that the patient can’t be scheduled without prior receipt of these items.

Unless an IME is being paid by attorney, we schedule IMEs 3 weeks in advance to allow for pre-payment and delivery of medical records.

 

Download Forms

Intake Form

Attorney Lien

 

Billing Questions

For billing questions, please send us an email  billing.uo@gmail.com

 

 

 

 

 

 

 

Attorneys and Adjusters

bottom of page