Tel: 1-888-690-1008
Downloadable forms

The following three forms are required by the Social Security Administration when you choose to have a representative. For your convenience we have made these forms available to you to print, sign and return to PCG to expedite the process.

Public Consulting Group
200 Fair Street Suite 2
Clarkston, WA 99403

Fax Toll Free: 1-888-290-2512


SSA - 1696 Appointment of Representative
Appoints PCG as the representative and allows PCG to file an application on behalf of the claimant.

SSA - 3288 Consent for Release of Information
SSA release allowing PCG to obtain information regarding your application or potential eligibility to SSDI benefits.

SSA - 827 Authorization to Disclose Information to the Social Security Administration (SSA)
An SSA specific form giving permission to a facility or person that is the custodian of medical information to release the medical information to Public Consulting Group (PCG) for the purpose of filing for SSA benefits.

If you have any questions regarding these forms please contact us.

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Public Consulting Group
Address
: 200 Fair Street, Ste 2 Clarkston, WA 99403
Telephone: 1-888-690-1008
FAX: 1-888-290-2512
E-mail: pcguaw@publicconsultinggroup.com