Intake Form

Thank you for your interest in our services.

Please complete the form below with as much information as possible.

    START A NEW CASE

    You are submitting a request to begin a new investigation with Covert Investigative Services (CIS). Please complete the form below and thank you for your business!

    CLIENT INFORMATION

    Client Name

    SUBJECT INFORMATION

    Subject Name

    Date of Loss

    		 Claim Number or File Number
    Subject Sex Subject Date of Birth



    Subject SSN
    		 Subject Phone

    CASE INSTRUCTIONS

    Specific Instructions / Objective

    Area(s) of Injury

    Restrictions
    Primary Area of Interest
    		Timeframe



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