To receive a payment from the Settlement Fund, you must complete and submit this Claim Form by June 04, 2019. Please read this form carefully and follow the instructions below.

You may submit the Claim online by clicking "File a Claim" below, completing the required information, and clicking "Submit" by June 04, 2019. You may also print out and mail the form, available on the Important Documents page, or return the prepaid postcard Claim Form if you received one in the mail, to: "Maxim Healthcare Settlement, c/o JND Legal Administration, P.O. Box 91054, Seattle, WA 98111", postmarked on or before June 04, 2019

To begin your claim, please enter the Claim ID number included on the settlement notice you received. If you no longer have the notice, you may email the Settlement Administrator for your Claim ID number at info@maximhealthcaresettlement.com or click "File a Claim" to skip this step.