> online forms
Below is a list of forms that are available for online submission. All forms are submitted using a secure encryption method to ensure that your private information is protected at all times.
Independent Medical Evaluation
Medicare Set-Asides - Worker's Compensation Referral
Medicare Set-Asides - Liability Referral
Rapid Assessment Program (RAP)
Please feel free to
with any questions.
15 Davis Avenue Suite 4 Poughkeepsie, NY 12603 phone 845-471-3801 fax 877-624-0553 email