Professional Legal Document Services, Inc.

Forms

Electronic Order Form

PLDS Electronic Order Form PDF [ 128 KB ]

Download our electronic order form; fill out and send it to our office via the submit button located at the bottom of the order form. If you're a new client, please contact our office to setup an account. Phone: (877) 797-7537

Authorizations and Releases

Alta Bates Summit Medical Center

Anthem Blue Cross/Blue Shield

Cedars-Sinai Medical Center

Centers for Medicare & Medicaid Services (Medi-Caid/Medicare)

County of Los Angeles - Department of Mental Health

Department of Health Care Services (Medi-Cal)

Department of Veterans Affairs

Employment Development Department

Generic HIPPA Authorization

John Muir Health - Behavioral Health Center

John Muir Medical Center

Kaiser Permanente (Northern California)

Kaiser Permanente - Healthcare Recoveries - Third Party Liability (Billing Request Form)

MedAmerica Billing Services, Inc.

Nevada DMV (Application for Individual's Records)

Nevada DMV (Application for Records Account)

Palo Alto Medical Foundation

Pomona Valley Hospital Center

San Francisco Fire Department

Social Security Administration (Earnings Information)

Social Security Administration (Medical Records Release)

St. Francis Memorial Hospital

St. Francis Memorial Hospital (Protected Health Information Request)

Stanford Hospital & Clinics (Health Information Management Services)

State of California Division of Workers’ Compensation (WCAB - Public Records Request Form)

U.S. Military Records

UC Davis Health Sytem

UCLA Healthcare

Walmart - Pharmacy

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