Instruction type:

Collation & Indexing
Chronology & Memorandum
Schedule of Radiology
Digital Booklet
Redaction

Additional Instructions (tick as appropriate):

Legal Aid Case (90 days payment terms)
Store digital records until claim concluded?
Dispose of original unpaginated records?
Dispose of blank/duplicate/photocopied records?
Summary Chronology Only? (As standard a detailed chronology will be provided)
Urgent turnaround needed?

If the following information is not provided in an accompanying instruction letter, please specify:

File Reference:
Firm Name:
Firm Address:
Fee Earner's Name:
Contact Email:
Contact Telephone:
Claimant Name:
Defendant Name:
Injury Date:
Case Type:
Record Providers:
1:
2:
3:
4:
5:
6:

Your Requirements:

Collation & Indexing
Chronology & Memorandum
Schedule of Radiology
Digital Booklet
Redaction
Records provided in disc rather than paper format?
Summary Chronology Only? (As standard a detailed chronology will be provided)

File Reference:
Firm Name:
Firm Address:
Fee Earner's Name:
Contact Email:
Contact Telephone:
Claimant Name:
Case Type:
No. of medical record providers?
Approx. no. of single sided pages:
Approx. no. of double sided pages:
No. of CD ROMs of Radiology:
Date: