Hire Gravitas Investigations | Gravitas Investigations

1Your Contact Info

2Your Subject's Info

3The Case Info

Client Name *

Client's Company's Name

Client's Address *

Address Line 1

Address Line 2

City

State

Zip Code

Client's Best Phone Number *

Client's Email Address *

Employer's Information

Add the Subject's / Claimant's employer's information

Employer's Contact Name

Employer's Business Name

Employer's Address

Address Line 1

Address Line 2

City

State

Zip Code

Employer's Best Phone Number

Employer's Email Address

Subject's Name? *

First

Middle

Last

What is the name of the person (AKA, The Subject) being investigated?

Aliases / AKAs / Maiden Name

First

Last

Social Security Number (SSN) *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Date of Birth *//

Best Phone Number

Gender *

Race

Height

Weight

Hair Color

Eye Color

Other Identifiers

Known Hobbies or Activities

Known Social Media Profiles and/or Usernames

Known Vehicles

Spouse's Name

# of Dependents

Select a Case Type *

Other Case Type

Claim Number / Case Number

Type of Loss / Injury

Date of Loss / Injury (if applicable)//

Medical Provider / Physician of Record (POR) (if applicable)

Upcoming Appointments / Known Future Locations

Physical Restrictions

Service Request Type *

Covert Surveillance
OpenEye Search (includes Social Media Canvass and Tracking)
Social Media Canvass
Social Media Canvass and Tracking
Hospital / Medical Canvass
Alive and Well Check / Permanent Total Disability (PTD) Check
Background Investigation (For Preemployment and Tenant Screening)
Other

Tracking Duration:

Daily (12 days)
Weekly (12 weeks)
Monthly (12 months)

Canvass Locations / Radius: *

Number of Locations: *

Location Type/s: *

Hospitals
Urgent Care Clinics
Doctor's Offices
MRI Facilities
Pharmacies
Chiropractors
Gyms / Health Clubs / Fitness Centers
Medical Centers
Orthopedic Specialists
Physical Therapists
Pain Management
Other (please specify)

Canvass Search Address (specify a location): *

Address Line 1

Address Line 2

City

State

Zip Code

Other:

Other Service Type

Red Flags (What led you to suspect abuse, fraud, and/or wrongdoing?) *

Budget *

Your answer should include the total dollar amount you'd like to spend or the number of surveillance days

Objectives *

Special Instructions

Do you have additional documents to provide? Upload them here (Medco 14, previous investigations, pictures):

File Upload

Due Date / Deadline//

Captcha *