Lien Information
Pueblo Radiology honors requests for lien work.
Form: The pdf below needs to be printed and signatures of the patient and attorney-of-record entered in the designated areas.
Phone: A phone call to our office will provide you with the anticipated amount needed on the document.
Fax: Once completed, please fax to 805.569.2964 and we will contact your patient to schedule their examination.
We will periodically follow-up with you regarding the lien. A lien coordinator in our office oversees this process and can be reached at 805.682.7984 x2052 if you have any questions or updates.
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