Client Intake

Submit case details below. Your submission will be sent to precisionmedicalconsultants@gmail.com.

Important: Do not upload PHI unless you have arranged a secure transfer method and any required agreements. For record transfer options, email us first.

Your Name

Role

Firm / Organization

Phone

Case Type

Case Summary

Key Deadline (optional)

Preferred Contact Method

I understand this form is for intake details only and I will coordinate secure transfer before sending any PHI.