Lester E. Cox Medical Center Ozark Professional Collections Springfield Hospital Class Action Fair Debt Collection Practices Act

If you would like to register as a potential member of the class action, please fill out this short form and click on SEND below to forward the information to us.

Full Name:
Spouse's Name:
Social Security Number:
Date of Birth:
Cox Medical Center Account Numbers:
E-Mail:
Address:
Telephone:
Cell Phone:
Dates of Letters Received From Ozark Professional Collections (OPC):
Dates of Telephone Calls Received From Ozark Professional Collections (OPC):
Amount of alleged debt owed to Cox Medical Center:
Please feel free to provide any additional information or ask questions below:

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