Your key to medical treatment.

If you are involved in Personal Injury Litigation and currently seeking medical attention simply fill-out this form and submit. You will be contacted within 24 to 48 hours.
                           

CONTACT INFORMATION

First Name:

Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
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Cell Phone:
Home Phone:
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Law Firm:  
Attorney Name:  
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Attorney Email:  

IMS Funding
11950 Jones Bridge Road
Suite 115-143
Johns Creek, GA 30005

(678) 590-1862

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