Thank You for stopping by our website! If you would like further information about our services please take a few moments to complete our new client application form. Of course, there is no obligation and all information is held in the strictest confidence.

Note: If your browser doesn't support forms, please email us at info@morgancurtiscollects.com

Registration Form

Name:
Firm:
Street:
City, State, Zip, Country:
Telephone (xxx-xxx-xxxx): REQUIRED
Fax (xxx-xxx-xxx):
Your e-mail: REQUIRED
Website (if applicable):
Type of business:
Products and/or services:
Average balance(s) on uncollected receivables:
Age of claim(s):
Contact person or collection manager:

• Important: We would like to furnish you with optimum results on your uncollected accounts. Please provide us with the requested information and any pertinent details of each account placed for collection so that we may effect a speedy recovery.
• When entering your claim(s) please be advised that Morgan & Curtis reserves the right to appraise same for collectibility prior to effecting a collection effort.
• We will contact you by phone or e-mail to confirm.

Type of account: Commercial Medical Retail Other
Debtor:
Street:
City, State, Zip:
Telephone (xxx-xxx-xxxx):
Contact person or guarantor (if different from debtor)
Services rendered: Fill in the box at right using the following suggested format for each item: Date (mm/dd/yy) - service rendered - amt. due Date (mm/dd/yy) - service rendered - amt. due
Would you like immediate action on this claim? Yes No

How did you hear about us: Search engine Internet ad Referral
Now that you have supplied us with the above information please press the SEND button below ONCE ONLY, please be patient as it may take up to a minute for your information to be transmitted to us.

Thank you!