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Citizens Disability is a non-government affiliated organization, dedicated to helping you get compensation for disabilities.

Update Your Medical Treatment Records

If you’ve recently had a visit with your regular doctor or another medical professional, please tell us about it! Staying current & up-to-date on your medical treatment will help us provide better service to you and help us prepare your case. Please use the form below to provide your update.

If you have any questions or need help, feel free to call us at 1-877-678-0935. Thanks!

Do you have an update regarding your medical treatment?

If you’re an existing client and have updated information about your medical treatment, please let us know. If we have any questions for you, a member of the Client Services team will be in touch with you directly.

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If your current email is not shown here, please enter your email address.
If the best phone number to reach you is not shown, please enter it here
Please type your full address here
Name of the treating medical professional
Address of the treating medical professional's office
City/town of the treating medical professional's office
Zip code of the treating medical professional's office
Phone number for the treating medical professional's office
Date of Visit*
Please enter the date of your visit with this medical professional
Consent*

By clicking "Submit" below I am providing my ESIGN signature and express written consent agreement to permit Citizens Disability, LLC to contact me at the number provided above for marketing purposes regarding Citizens Disability services, including a disability claim, benefits optimization, Medicare, and/or pharmacy services, and customer care messages, such as information and reminders regarding your disability claim. I understand that these calls and/or SMS/MMS messages include those using automated technology, AI generative voice, and prerecorded and/or artificial voice messages. I confirm that the phone number above is accurate, and I am the regular user of that phone. I also agree to Citizens Disability’s SMS Terms and Conditions and Privacy Policy. For SMS messages campaigns, text “STOP” to stop and “HELP” for help. Message frequency may vary. Msg & data rates may apply. I acknowledge that my consent is not required to obtain any good or service, and to contact Citizens Disability without providing consent I can call 833-243-2965.

This field is for validation purposes and should be left unchanged.

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