Doing Business with Us

Information Request

Please tell us about yourself and your organization:

Request Information

Fields in bold are required.

Medical
Banking / Finance
Telco / Utility
Credit Card
Other:

Collections
Outsourcing: Extended Business Office, Early-Out
Medical Billing
Other:
Optional Information

By also answering the following questions, we will be able to answer your questions more specifically.

Type of Accounts:

Yes       No
0 - 90 days
90 - 120 days
120 - 150 days
150+ days
Yes       No
Manual Electronic Media
Monthly
Quarterly
One time focus project

This communication is from a debt collector. This is an attempt to collect a debt and any information obtained will be used for that purpose.