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Salem Chiropractic Clinic Brian Herren, DC 1765 State Street Salem, Oregon 97303 Workers Compensation QuestionnaireFull name: ___ Todays date: ___ Employer: ___ Employer phone: ___ Employer address:
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The DC Chiropractic Center is near downtown Washington, DC.
All chiropractic centers in the DC area are required to file.
You can fill out the DC Chiropractic Center form online or by mail.
The purpose of the DC Chiropractic Center form is to report information about chiropractic services provided in the DC area.
Information such as the number of patients seen, types of treatments provided, and billing information must be reported.
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