Regarding Assignment Pdf Form

State:
Multi-State
Control #:
US-PI-0014
Format:
Word; 
Rich Text
Instant download

Description Irrevocable Assignment Form Complete

This form authorizes the release of the client's medical information to the client's attorney and creates an irrevocable assignment and lien on the proceeds of any judgment for medical bills and expenses.
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Irrevocable Form Assignment
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