Requesting Company Req_Company
Requestor Name Req_Name
Requestor Address Req_Address
Requestor Telephone Req_Telephone
Requestor Email Req_Email
File Number File_Number
Type of Investigation Invest_Type
How Much Investigation amounthowmuch
Claimant's Last Name Subject_Last
Claimant's First Name Subject_First
Address Subject_Address
Social Security Number Subject_SS
Date of Birth Subject_DOB
Telephone Number Subject_Tel
Date of Loss Date_Of_Loss
Injury Type Injury_Type
Insured Insured
Claimant Represented  Claimant_Rep
Pending Medical Exams Pending_Exams
Date/Time of Exam Date_Exam
Location of Exam Location_Exam
Doctor or Exam Company Exam_Doc
Scheduled Hearings Hearings
Hearing Date/Time/Location Hearing_Info
Additional Notes Notes
Confirm Order By Verify