Get in Touch
Contact KWVRS
Ready to discuss your case? Our team responds quickly to inquiries from attorneys, insurers, and claimants seeking vocational and rehabilitation expert services.
Retain KWVRS
One adaptive digital intake form covers our Professional Services Agreements: it adjusts its questions to your case type and routes to the matching agreement. Open it below to start.
Medical Records and Intake Forms
Personal history questionnaire and HIPAA authorization, in English and Spanish. Download the PDF, complete and sign it, and return it via the secure upload link we provide - see all on the forms page.
- Personal History Questionnaire (English)Background questionnaire on health, function, and daily activities for the evaluation.
- Cuestionario de Historia Personal (Español)Cuestionario sobre salud, funcionamiento y actividades diarias para la evaluación.
- HIPAA Authorization (English)Authorization to release protected health information for the evaluation.
- Autorización HIPAA (Español)Autorización para divulgar información médica protegida para la evaluación.
Our Offices
New Jersey - Headquarters
- Hackensack, New Jersey
- (201) 343-0700
- info@kwvrs.com
Virginia - Richmond Office
- Richmond, Virginia
- (804) 282-4199
Office Hours
- Monday - Friday9:00 AM - 5:00 PM ET
- Saturday - SundayClosed
After-hours inquiries are accepted via email and will be responded to the next business day.
Request a Consultation
Tap to call (201) 343-0700What happens next
- 1Conflict check within 1 business day.
- 2Fee quote sized to the engagement.
- 3Engagement letter and records-request checklist.
KWVRS treats pre-retention communications as confidential. Whether consulting-expert work-product protection applies depends on the retention and the rules of the forum; exercise your own judgment before sending privileged material.