Contact Your Claims Representative

As a CorVel claimant, we are happy to assist you in contacting your claims representative. Please take a moment to fill out the short form below. You should expect to be contacted by CorVel shortly. All fields must be completed in order for your request to be processed.
First Name:    *
Last Name:    *
Address 1:    *
Address 2:   
City:    *
State:    *
Zip Code:    *
Phone:    *
Email:    *
CorVel Contact:    *

Additional Information
Employer:    *
Claim Number:   
Physician name:   
Claim Type:    *
Additional Comments:


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