Please complete one of the forms below and submit it online to the Risk Management Office as directed on the form. Injured due to another's negligence or carelessness?The law allows you certain rights. Fill out an intake form for a personal injury case and we will be in touch! Employment Intake Form. Fill out the contact form or call us at 855.370. 2828 to schedule your free consultation. Start Your Free Consultation! We'll get a complete record of all your medical bills and the costs for any medical reports. Pay any outstanding healthcare claims.