Liability Referral Intake Form
GETTING YOUR LIABILITY REFERRAL INFORMATION TO SABER
Directions for Downloads
- Click on the first circle below to open the form in a new window tab
- To download, click the down facing arrow in the upper right corner
Information we will need:
- The last two years of treating physician records
- Prescription drug printout from claimant’s pharmacy
#1 DOWNLOAD
Click the circle icon above to open the form in a new window. Use the download button in the upper right corner to save to your desktop.
#2 FILL OUT
Once you've downloaded the intake form, fill it out to the best of your ability with the information requested. You'll be submitting it separately.
#3 SEND
Send the form directly to your Saber Solutions contact, along with the information we need listed above these steps. We'll take it from there!
Still need a contact at Saber Solutions? Reach out to us today!