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We are working on improving the security and usability of our online request form.

In the meantime, please call 516-935-8747 to request an exam, or click the pdf icon below for a copy you can save and email to imerequest@jurissolutions.com, or print and fax to 516-935-8748.

Print IME Request Form in Adobe PDF format.

Thank you for your patience while we work to improve services for our valued clients.

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