Forms - Giupedi

HIPAA Authorization for Release

This form is required for our team to work directly with the provider to negotiate discounts on medical bills submitted on patient’s behalf.

Complete Form

Physical Location:
1100 1st Avenue, Suite 701
King of Prussia, PA 19406

Please Mail All Correspondence To:
P.O. Box 61927
King of Prussia, PA 19406

Physical Location:
1100 1st Avenue, Suite 701
King of Prussia, PA 19406

Please Mail All Correspondence To:
P.O. Box 61927
King of Prussia, PA 19406

P 1-833-765-CMBS (2627)

F 1-484-468-1509