Legal Referral Information...

Complete the form...

Referral Form

Fill out the information in the form above then fax to the number below. For problems or questions, please contact:

John J. Campbell-Esq.
Telephone: (303) 290-7497
Fax: (720)200-2771
email: askmai@medicareallocations.com

Some documents on this page are Adobe PDF files. If you do not have Adobe Acrobat Reader, click the button to download.

This process uses an Adobe PDF form. Note that the information can not be saved on your computer unless you have Acrobat 7.0 Professional or later. You would need to print a copy for your records.

For users that have Adobe Acrobat 7.0 Professional
For users that have Adobe Reader 6.0 - 7.0