Please contact us for any questions on:
-Billing
-Receipts
-Medical Records
-Misc Request
-Insurance Questions

Billing

Insurance Verification

Records Request

Misc: Please type specific request below

Which office do you typically visit?

Phone *

First Name *

Last Name

Email *

Date of birth *

Please describe your request *

If requesting records, Please click here to download our medical release form.

If submitting for Insurance Verification, Upload Picture of the Front of Insurance Card

If submitting for Insurance Verification, Upload Picture of the Back of Insurance Card

Please be advised that requests for records or billing may take up 7-10 business days. By Providing Your Phone Number, You Agree To Receive Text Messages From Prodigy Chiro Care & Spinal Rehab. Message And Data Rates May Apply. Message Frequency Varies.