File Referral

File Referral Form

Patrico, Hermanson & Guzman, A P.C. appreciates you and your business. You can refer a file to our offices using the web form below, via U.S. mail or by emailing us at directly at Sean.Hermanson@phglaw.com or call 858-874-2109. We encourage you to complete the secure file referral form below.

We will contact you within 24 hours upon receipt of your file. Thank you for your business and your trust.

Name*
First Last
Email*
Phone*
Employee Name
Employer Name
Date of Injury
Date Format: MM slash DD slash YYYY
Date of Hire
Date Format: MM slash DD slash YYYY
Date of Birth
Date Format: MM slash DD slash YYYY
Claim Number(s)
WCAB Numbers
Carrier
Venue
Part of Body
Examiner's Remarks
Examiner
Company
Date
Date Format: MM slash DD slash YYYY
Phone
Email
File Upload
Drop files here or
Comments
This field is for validation purposes and should be left unchanged.