MSA Referral Form

Download the
Referral Form

To send a referral to Mackler Associates, please complete our referral form, select appropriate service and forward to or mail to:

Mackler Associates
121 Wilder Terrace
West Springfield, MA 01089

What we will need for an MSA:

  • First Report of Injury/Accident
  • Two years (from last date of treatment) of medical records
  • Two years (from last date of payment) of payment history
  • Two years (from last date of medication provided) of pharmacy history
  • Compensable injury/accident-related condition
  • Denied injury/condition

Please feel free to contact me at any time if you wish to discuss the particular circumstances of your case. Call (413) 391-0856 or e-mail