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Collection Services Application

To sign up with CRM please follow these instructions:

  1. Click on the icon to open up our one-page Collection Services Application (CSA);
  2. Review the Terms and Conditions of Collection Services as linked HERE and on the CSA;
  3. Save the form to your computer and then open it with your PDF viewer;
  4. Fill in all the required fields;
  5. Save and Print the completed form to sign; and
  6. Return the signed form to us via email ( or fax (516-430-5015).


Once you have sent in your completed application, you are ready to start submitting claims to us for collection by clicking HERE
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