MEDVAL

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Please check off the documents you’d like to receive:
 Sample Workers’ Compensation MSA (WCMSA)
 Sample Liability MSA (LMSA)
 Sample Conditional Payment Request
 Sample Settlement Agreement and Model Language (WCMSA)
 Sample Settlement Agreement and Model Language (LMSA)
 Self-Administered MSA Terms and Conditions
 Sample Custodial Agreement
 CMS/SSA Release Package
 Hard Copy Referral Form MEDVAL White Papers

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