Professional Services | Mark Frobb MD

How can we help you?

I would like to schedule Dr. Frobb to perform an Independent Medical Examination (IME).

I would like Dr. Frobb to prepare a medical legal report, supplementary medical legal report, or a responding report on a patient who was in his care.

I would like to schedule a phone consultation with Dr. Frobb.

SCHEDULING AN IME:

Client's Full Name(required)

Date of Birth(required)

Client PHN (Personal Health Number)(required)

Contact Person(required)

Email address(required)

10 Digit Telephone Number

Firm Name

Name of Acting Counsel(required)

Mailing Address

Preferred Date of IME

Preferred Time of IME

Additional Information

Select all that apply

MEDICAL LEGAL REPORT

SUPPLEMENTAL MEDICAL LEGAL REPORT

RESPONDING REPORT

Client's Full Name(required)

Date of Birth

Client PHN (Personal Health Number)(required)

Contact Person(required)

Email address(required)

10 Digit Telephone Number

Firm Name

Name of Acting Council

Contact Preference

eMail

Phone

Name of Counsel(required)

Name of Firm

Email address(required)

10 Digit Phone number + Ext.

Best date to call

Best time to call

Your Client's Name(required)

Client's Date of Birth(required)

PHN (Personal Health Number)(required)

If you wish to email a copy of an existing medical records release document for this patient, CHECK BELOW

Select file to be emailed

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Maximum size 10MB

Please confirm contact email address(required)

Type the characters below before "Submit"(required)