Comments & Referrals
button_bg.gif (5229 bytes) CUSTOMER COMMENTS   |   ONLINE REFERRALS    

















SEND US A REFERRAL

Use our easy online e-Referral form below. If you have only a paper copy of
the "first report of injury" you can FAX that to (605) 361-1106


Your Name:
Your Email Address:
Your Contact Telephone:
Company Name:
Patient Name:
Employer Name:
Claim Number (if known):


Attach FROI:
Add attachment (First report of injury).
Only PDF or Microsoft Word RTF files can be uploaded.

Type of Referral :
Comments:



  Copyright © 2017 - OHARA, LLC.
OHARA, LLC
PO Box 89527
Sioux Falls, SD 57109
P: (605) 361-1071
F: (605) 361-1106