Request for Medical Claim Information

Welcome to The Rawlings Group online questionnaire!

* Required fields are indicated by an orange asterisk

Contact Information - Language Selection

* Please choose a language.  


To contact us, please call the toll-free number listed on your questionnaire.
We are available between the hours of 8:30 AM and 8:00 PM (Eastern Time Zone). To protect your privacy, your session will automatically end after 45 minutes of inactivity. Any information you enter up to that point will not be saved. If this occurs, please log in and begin again. Thank you!

Our mailing address is:
The Rawlings Group
c/o Subro Web Questionnaire
PO Box 2000
LaGrange, KY 40031-2000