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Injury Management Organization provides the following forms for your convenience. Please give as much information as possible. Contact Claudette Burns with any questions or concerns at 972.404.8133 or 888.645.1200. For general information Click here to complete our e-mail form.
For medical case management referrals Click here to access our authorization release form.
For pre authorization forms Click here to access our pre authorization request form, or print a PDF and fax the form to 972.991.5572 or TOLL FREE 888.275.9946.
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