Allocation and Medicare Set-Aside Forms
The Social Security Administration (SSA) Form 3288 and the Health Information Disclosure Form are necessary components of each Medicare set-aside claim. The links below are PDF documents that, for your convenience, can be printed, signed, and faxed to our office at (561) 998-0488.
- SSA-3288
- Claimant Authorization Form
- Social Security Release Form
- Allocation Referral Form (pdf) (MS Word)
David Gold, Attorney At Law
"In claims that PMR's in-house physicians found to be meritorious, their assistance has been invaluable... They have found extremely highly qualified medical experts to support our cases..."
Robert Boyers, Attorney at Law
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