MSA Evaluation Intake Form

Please fill out the form below.


  • *Please submit all intake documents and copy of advanced fee.
  • Claim Information

  • Injury Victim Information

  • Plaintiff Counsel

  • Defendant/Insurance Carrier

  • Step 1: SSDI/Medicare

    *VERY IMPORTANT – please completely fill out this section
  • Step 2: Future Care

  • Step 3: Settlement Verdict Details

  • Other Health Care Coverage

  • *Please provide any proposed settlement documents, summary of the case and Medicare card, if applicable.

TESTIMONIALS

"I was smart enough to hire Synergy Lien Resolution Services. Kudos to Synergy for tracking down ALL the medical bills, hounded Medicaid to pay them all, got all providers to state zero balances and then negotiated Medicaid down to accept $30K [down from 200k] to wipe out all of the medical bills."

Marianne Howanitz, Esq
Marianne Howanitz Law Offices

"Synergy is an invaluable partner in the mediation process. They have extensive expertise in Medicare, Medicaid and Structured Settlements and the ability to explain the impact of these complex concepts to my clients in simple, clear and understandable language. This allows me to focus on obtaining the best possible result in the settlement process."

Michael J. Winer, Esq.
President Florida Workers Advocates (FWA)

Premier Clients

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Ready to schedule a consultation?

The Synergy Settlements team will work diligently to ensure your case gets the attention it deserves. Contact one of our legal experts and get a professional review of your case today.

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