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available from 08:00 – 18:30
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We will need some important documents
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To expedite the process, please send this now in order to speed up the process at the medical office. For better quality, scan the following documents, otherwise, please take a picture of the following on a matte, black background with your mobile phone.
Please upload your files in the form above
Please provide the front and back of your:
1.- Identification (ID): Passport, US Driver’s License (DL), Immigration Card, State ID, any government issued ID.
2.- Insurance Card: If automobile accident, please provide your insurance company issued card.
3.- Insurance Card: Kindly also include the front and back of your private insurance company (private, Medicaid, Medicare, HMO, etc.)
4.- Police Report
5.-Accident/Incident Report
2.- Insurance Card: If automobile accident, please provide your insurance company issued card.
3.- Insurance Card: Kindly also include the front and back of your private insurance company (private, Medicaid, Medicare, HMO, etc.)
4.- Police Report
5.-Accident/Incident Report
Please upload your files in the form above