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WEST ODESSA CHIROPRACTIC CLINIC 1319 W. 22ND ST. ODESSA, TEXAS 79763 ×432× 3327882 / Fax # (432× 3322446 ASSIGNMENT OF PROCEEDS, CONTRACTUAL LIEN AND AUTHORIZATION (“AGREEMENT “) I hereby direct
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How to Fill out West Odessa Chiropractic Clinic:

01
Visit the clinic's website or call them directly to schedule an appointment.
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Arrive at the clinic on the specified date and time of your appointment.
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Fill out any necessary paperwork provided by the clinic, such as a patient intake form.
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Provide accurate and complete information on the form, including your personal details (name, address, contact information) and medical history.
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Double-check the form for any errors or missing information before submitting it.
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If you have any specific concerns or issues, communicate them to the clinic staff or chiropractor during your visit.
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Follow the instructions and recommendations given by the chiropractor during your session at the West Odessa Chiropractic Clinic.

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Individuals experiencing chronic or acute pain in their muscles, joints, or spine.
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West Odessa Chiropractic Clinic is a medical facility that provides chiropractic care services.
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The healthcare professionals need to accurately report patient information, treatments provided, and any relevant documentation.
The purpose of West Odessa Chiropractic Clinic is to provide chiropractic care services to patients.
Patient demographics, treatment records, diagnostic tests, and billing information must be reported on West Odessa Chiropractic Clinic.
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