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Moon Valley Chiropractic PI Intake Forms James Reich ow, DC TH 15420 N. 7 Street, Suite B, Phoenix, AZ 85022 / Phone (602)2980292 / Fax (602)2986961Name Age:Referred by Date of Birthday:AddressStateZipCell
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Moon Valley Chiropractic PI refers to a personal injury claim related to chiropractic services provided at Moon Valley Chiropractic.
Individuals who have received chiropractic treatment due to an accident or injury and wish to seek compensation for their medical expenses and other damages are required to file a Moon Valley Chiropractic PI.
To fill out a Moon Valley Chiropractic PI, collect all relevant medical records, fill in personal information, detail the injury and treatments received, and submit the claim form to the appropriate insurance company or legal entity.
The purpose of the Moon Valley Chiropractic PI is to provide a formal mechanism for individuals to seek compensation for injuries sustained that required chiropractic care.
Information that must be reported includes personal identification details, description of the injury, the treatment received, associated medical costs, and any relevant accident details.
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