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WildCard Investigations Inc
., is a fully licensed and insured investigative agency providing a comprehensive range of investigative services to attorneys, insurance companies, third party providers, government entities and private individuals, with our focal point on insurance defense. WildCard provides superior service at competitive prices by licensed investigators throughout the state of Florida.

A JP Merlano Florida Private Detective Agency
Lic# A-2300209.

Please fill out form to submit your request. All requests are handled confidentially.

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* Requestor Name:   Company/Firm
* Phone Number :   Client File No :
* Type of Claim :   If new requestor, include
Street Address::
Unit or Apartment:   * City:
State:   FL * Zip Code:
Alternate Phone:   Fax Number:
* Email Address:      

Claimant Information Below

Claimant/Subject Last Name Known Vehicles:
First Name: * State Currently Licensed
Middle Name or Initial: Driver License Number:
Last Known address: Date of Injury mm/dt/year :
City : Type of Injury:
State: FL Job description
* Zip Code: Accident Description:
* Phone Number: Physician/Attorney/MRI/IME
date (mm/dt/year )
Age: Time of Incident:
Date of Birth (mm/dt/year ): Location(City) :
Height: Physic an Name and Address:
Race: Physician Phone Number:
Sex:  Male  Female Is the claimant in Physical therapy? Y or N:
Weight: Where and Phone Number? :
Build: Is the claimant receiving benefits? Y or N:
Hair Color: Is the claimant Represented? Y or N:
Hair Length: Claimant's Attorney Name:
Marital Status: Claimant Firm Name:
Spouse Name: : Defense Attorney:
Other Physical Characteristics: Defense Firm Name:
Hair Color Insured Company Name:
Number of Dependents:: Insured Contact Name:
Insured Street Address include city and state and zip
Insured Contact Phone Number:
Services desired:
Due Date (mm/dt/year ):
Number of Surveillance Days:
Objective/Scheduling Preferences:
Special Instructions:

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