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Service Order Form

It is essential that the right specialty provider is selected to perform an independent medical evaluation so that you may obtain the most accurate information for making claims decisions.

Please complete the Service Order Form below and submit to IME, PC.  Our medical staff will review your request and begin the process of locating the best provider for your claim.

If you are not sure what specialty to choose, we recommend that you consult one of our Legal Nurse Consultants at IME, PC to help you determine which specialist is the most appropriate for your claim.   

Please call us at 1-800-968-4637 or send an email to

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Providing NATIONAL

Comprehensive Medical Legal

Since 1986