Liability Referral Intake Form - Saber Solutions
18166
page-template,page-template-full_width,page-template-full_width-php,page,page-id-18166,bridge-core-2.9.1,qodef-qi--no-touch,qi-addons-for-elementor-1.8.0,qode-page-transition-enabled,ajax_fade,page_not_loaded,,side_area_uncovered_from_content,qode-child-theme-ver-1.0.0,qode-theme-ver-27.5,qode-theme-bridge,qode_header_in_grid,wpb-js-composer js-comp-ver-6.7.0,vc_responsive,elementor-default,elementor-kit-17993
 

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!