If you wish to have the our office prepare a claims history and insurance verification
letter for the time you were employed at Augusta University, please complete the Authorization
and Release form below and fax it to 706-721-8014 or email to firstname.lastname@example.org.
Please note that there is a $20 processing fee for the Authorization and Release Form.
We accept the following forms of payment:
- Visa or Mastercard payments are accepted and will be processed by calling 706-737-1767
- Check payments are accepted as along as checks are made payable to "Augusta University”
- Mail checks to Augusta University, Cashiers Office, 2500 Walton Way, Payne Hall, Room
4B, Augusta, GA 30904.
Claims history request require several days turn around time, therefore, please do
not expect to receive the requested information the day after you send your request
to the Legal Affairs Office.
Claims History and Insurance Verification Authorization Form