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Consent Form

I authorize my attorney_______________________ (please fill in the name) to provide Titan Financial with all necessary information pertaining to my case which may include police reports, pleadings, medical information i.e. medical records, medical bills, and insurance coverage. This consent authorizes Titan Financial and its staff to use the information received to process my loan application.

Check here to authorize your attorney to send your case information for evaluation by Titan Financial.

Submitting this application does not guarantee that Titan Financial will provide you with a loan applied toward your potential settlement. In addition, submitting this information is not a guarantee that the applicant will accept any potential loan offers provided by Titan Financial.