Regulated or restricted fields like Health Care make collecting training data complicated. We all want to do the right thing, but how? This talk will look at how Fight Health Insurance used de-identified public and proprietary information to create a semi-synthetic training set for use in fine-tuning machine learning models to power Fight Paperwork. We'll explore how to incorporate the latest "reasoning" techniques in fine tuning as well as how to make models that you can afford to serve — think single GPU inference instead of a cluster of A100s. In addition to the talk we have the code used in a public GitHub repo — although it is a little rough, so you might want to use it more as a source of inspiration rather than directly forking it.