Investigation Intake Form Select Case Type Choose the type of investigation you need ⚖️ Liability Personal injury & liability claims 🦺 Worker's Comp Workplace injury investigations 📋 Disability Disability claim investigations 🚚 Cargo Cargo theft & transport claims 🔍 Other General investigations Re-Open Case 📂 Re-Open Case enabled. You'll need to enter the MIG# on the next page. Continue → Case Information Enter the basic case details Assignment Date: Re-Opening MIG Case # * Claim Number * Date of Loss * Assignment Due Date 🚨 Rush Assignment Normal turnaround is 30 days. Assignments due within 14 days of assignment date are considered rush. ← Back Continue → Subject Information Please provide as much information as possible about the subject(s). The more details you provide, the greater our chances of successfully locating and identifying them. Subject 1 Primary First Name * Middle Name Last Name * Unknown Subject Date of Birth SSN Sex Select... Male Female Spouse / Relative Name + Add Physical Description Race / Ethnicity Height Weight Hair Color Eye Color Distinguishing Marks Subject Address Information Street Address Apt # City State Zip Subject's Phone Subject's Email Known Social Media i Additional Information + Add Another Subject (1/4) ← Back Continue → Supporting Documents Help us investigate more effectively by uploading relevant documents Documents to Include 🚗 AccidentReports 💳 Driver'sLicense 👤 Photos ofSubject 📷 ScenePhotos 🏥 MedicalRecords 📄 PoliceReports 📎 Click to select files or drag and drop PDF, Word, Excel, Images (Max 10MB each, up to 5 files) ← Back Continue → Vehicle Information Enter vehicle and accident details if applicable Vehicle Year Make Model Plate Number Subject's Driver's License Subject's Insurance Carrier Loss Location Insured Name ← Back Continue → Employer Information Enter the subject's employment details if known Subject's Employer Employer Phone Employer Street Address Employer City Employer State Employer Zip ← Back Continue → Injury Information Enter details about alleged injuries and medical treatment Alleged Injury Emergency Treatment at Treating Physician Medical Providers & Upcoming Appointments ← Back Continue → Services Requested Select services for each subject Subject 1 Primary Internet Investigations Internet Presence Review i Internet Presence Audit i Internet Presence Monitoring i Internet Scene Canvass i Select Days... 30 Days 60 Days 90 Days Jury Internet Voir Dire i Surveillance Surveillance Days i Recurring Surveillance i Select Days... 30 Days 60 Days 90 Days SIU Services Cargo/Vehicle/Trailer Theft i Fraud Referral/Review i Record/Video Retrieval i Scene Investigation i Statements/Interviews/EUO i Investigative Services Background Check i Activity Check i Alive & Well Check i Asset/Income Check i Decedent Check i Employment Check i Employment History i Pre-Employment Check i Pharmacy & Medical Canvass i Skip Trace i Other Services* i Internet Investigations Internet Presence Review i Internet Presence Audit i Internet Presence Monitoring i Internet Scene Canvass i Select Days... 30 Days 60 Days 90 Days Jury Internet Voir Dire i Surveillance Surveillance Days i Recurring Surveillance i Select Days... 30 Days 60 Days 90 Days SIU Services Cargo/Vehicle/Trailer Theft i Fraud Referral/Review i Record/Video Retrieval i Scene Investigation i Statements/Interviews/EUO i Investigative Services Background Check i Activity Check i Alive & Well Check i Asset/Income Check i Decedent Check i Employment Check i Employment History i Pre-Employment Check i Pharmacy & Medical Canvass i Skip Trace i Other Services* i Additional Instructions ← Back Continue → Client Information Enter the referring client and contact details Company Information Company Name * Address * Address 2 City * State * Zip * Contact Information First Name * Last Name * Email * Phone * + Add Secondary Contact Secondary Contact (CC on Reports) First Name Last Name Email Phone ← Back Submit Request
