SCHEDULING REQUEST

Tell us what you need.

Use this short, non-PHI request to tell Allied the evaluation type, physician if known, appointment format, and general California area. Allied’s Scheduling & Intake team will route the next step.

Privacy-first intakeAfter the initial contact, Allied can direct you to the appropriate secure process for case-specific materials.

INITIAL CONTACT

Tell us how to route your request.

Provide your business contact information and the type of evaluation support you need. Allied will route the appropriate next step.

Do not include PHI or case details.No injured-worker name, diagnosis, records, claim number, date of birth, or other sensitive information.

1. Tell us what you need

Choose the evaluation type, physician if known, appointment format, and a general California city or area.

Request typePhysician of interest (optional)Preferred appointment formatPreferred city or area (optional)Routing note (optional)

1. Tell us about your practice

A few professional details help Allied route your physician inquiry to the right conversation.

Specialty / disciplineQME statusWhat are you interested in?Practice city or area (optional)LinkedIn profile (optional)What would you like Allied to know? (optional)

2. How should Allied follow up?

Provide business contact information only. Allied will coordinate case-specific information through the appropriate secure process.

Your nameOrganizationWork emailPhone

Business contact only. Do not include injured-worker names, claim numbers, dates of injury, medical records, or other protected health information. Allied will coordinate case details through the appropriate secure process.

Thank you. Allied received your inquiry and will follow up.

We could not submit the form. Please call Allied at (951) 889-7261 or use the appropriate contact email.