CMS Release Form

CMS Release Form (Spanish)

Social Security Form 3288

Conditional Payment Requirements for a Workers’ Compensation Case

Conditional Payment Requirements for a Liability Case

HICN/SSN Collection Form

Medicare & You

Medicare & You (Spanish)

Self-Administration Tool Kit

Claimant Self-Attestation Form (Lump Sum)

Claimant Self-Attestation Form (Structured)

CMS Memorandums and Related Materials

Additional sample files available by request, see the Find Out More page for more information.