Transfer Care - Kura MD, Inc.

855-KURA220 support@kura.md

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Transfer Care

Complete and submit the form below to transfer care to Kura MD

To begin a workers’ compensation injury claim with Kura MD, please enter the details of the claim below
or securely send your claim information via FAX at: 888 965 4067.

I am a
- Injured Worker
- Employer
- Insurance Carrier
- Nurse Case Manager
Patient / Injured Worker Information
Patient Name
First Last
Date of Birth
Patient Biological Gender
- Male
- Female
Preferred Language
Phone
Phone Type
- Home
- Cell
- Work
Phone Type
- Home
- Cell
- Work
If you don't know the type, then select "Home."
Can we leave a voicemail related to the injury at this phone number?
- Yes
- No
Email
Injury Information
Date of Injury

If you are not sure of the exact date, please provide the nearest approximate date.
Where did the injury occur?
Employer Information
Employer Company Name
Employer Contact Name
First Last
Employer Phone
Employer Email
Insurance Information
Insurance Carrier Name
Insurance Claim Number
Insurance Contact Name
First Last
Insurance Contact Phone
Insurance Contact Fax
Insurance Contact Email
Nurse Case Manager Information
Nurse Case Manager Organization
Nurse Case Manager Name
First Last
Nurse Case Manager Phone
Nurse Case Manager Email
Additional Comments
Fax authorization and medical records to (888) 965-4067
Please describe how the injury occurred. Include all body parts that have been affected.
Please include accepted body parts and the scope of treatment being requested (E.g., PTP services, request for one time consultation impairment rating, etc).
File Attachments
Drop files here or

Accepted file types: pdf, jpg, png, gif, docx, doc, xls, xlsx, rtf.
View Agreement
I have read the Kura MD Terms of Service*
- I Agree

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Corporate Office

Kura MD, Inc.
130 Diamond Creek Place
Roseville, California 95747

Toll Free: (855) Kura220 or (855) 587-2220
Secure Fax: (888) 965-4067
Email: info@kura.md

Press Room

Kura MD Enters Network Agreement With Coventry to Be a Provider of Telemedicine Services for Workers’ Compensation.
Kura MD, Inc. Welcomes Former AIG Executive Don Hurter to Its Board of Advisors
Arissa Announces Release of Workers’ Compensation Telemedicine Services With Kura MD
Kura MD Acquires Assets of The Telemedicine Group, Assumes Management of TeleMed2U
One Young Roseville Med-Tech Firm Buys Another, Gets More Funding

Who is Kura MD?

Kura MD provides a secure audio/video telehealth platform, medical coordinator call center, and physicians for online medical consultations for workers’ compensation and general health.

Why Use Kura MD?

Kura MD’s SaaS WC TH platform allows providers to deliver medical services to the patient at work, home, or while traveling by phone, or online using a smartphone, tablet, or computer. Our proprietary telehealth technology platform provides greater access to healthcare, while reducing healthcare costs. You can "See the Doctor Now” using the Kura MD WC TH platform.

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