MITNICK LAW OFFICE, LLC

Litigation and Claim Resolution Firm

"PROTECTING THE PAST, THE PRESENT & THE FUTURE"

NFL CONCUSSION CLAIM FORMS & DOCUMENTS

Formal claim forms issued by the Concussion Settlement Claims Administrator should become available in the first quarter of 2017.

The forms below are available for use by Mitnick Law Office Clients

Initial Mitnick Law Office Intake application required for Retired NFL Player Concussion Claims
Click Here to access the Claim intake application:

 

Mitnick Law Office Medical Questionnaire required for Retired NFL Player Concussion Claims
Click Here to access the medical questionnaire:

 

Mitnick Law Office Medical Records Authorization Form (HIPAA) required for Retired NFL Player Concussion Claims
Click Here to access the HIPAA release:

 

Mitnick Law Office Employment Records Authorization Form required for Retired NFL Player Concussion Claims
Click Here to access the Employment records authorization form:

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