Legal Community

Fill out our simple Client Pre-Approval form below and we will expedite FREE Home Delivery of your client's medications.

Get Your Lien Client Pre-Approved Now.

One Contact

& Billing Team.

for All Pharmacy Locations

We partnered with local pharmacies across the Valley to create the Lien Rx Network – now offering 16 walk-in locations. All correspondence and billing is coordinated through the Las Vegas Pharmacy team to expedite service.

Lori Ortale, Managing Pharmacist

Fill out the form below. We'll contact you soon.

"*" indicates required fields

Choose Pharmacy*

Attorney Firm Name

Attorney's Name*

First Last

Attorney's Email*

Attorney's Phone*

Is there a Case Manager?*

Yes

Case Manager's Name*

Case Manager's Email*

Client's Name*

First Last

Client's Date of Birth*

Client's Phone*

Client's Email

Date of Accident*

Amount of Pre-Approval

Name of Physician's Practice*

Physician's Phone*

Special Instructions...*

This field is for validation purposes and should be left unchanged.