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Join our network

Become part of our selective medical network

By joining our medical community, you'll become part of a select group of healthcare professionals and facilities dedicated to providing crucial support for personal injury and workers' compensation attorneys.

Step 1

First, fill out this form to start the process.

Step 2

Next, we will contact you promptly to set up a discussion on how to join our network.

Step 1

First, fill out this form to start the process.

Step 2

Next, we will contact you promptly to set up a discussion on how to join our network.

Ready to get started?

Please fill out the form below.

    Provider Information

    First Name:
    Last Name:

    Please choose your specialty:

    Business Name (DBA):
    Main Practice Address:
    City:
    State:
    Zip:
    Main Practice Location Phone: Example: (555) 555-5555 or 555-555-5555
    Main Practice Location Email:

    Form Completed By

    Completed By Name:
    Completed By Email:
    Completed By Phone:
    Extension:
    Comments:

    Completion of this application request form indicates your interest only.

    We will be contacting you regarding next steps. You can expect a response from Bridge Med Legal promptly. You can also contact us at info@bridgemedlegal.com for any additional inquiries.

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