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Agent: This should take about five minutes. I’ll ask a few quick questions so the doctor can review options that may be covered under your claim, like medications, creams, patches, gels, therapies, medical devices, or Red Light Therapy when appropriate. Before we start those questions, is it okay if this call is recorded for documentation?

Quick trust and safety check

After the opener, confirm these four items and continue to contact details.

Recording permissionConfirm the patient said yes to recording.

Current locationAsk: “What city and state are you in right now?”

Safe place to talkAsk: “Are you in a safe and private place to talk?”

Work statusAsk: “Are you full duty, modified duty, or off work?”

First nameRequiredRequired before completion.Last nameRequiredRequired before completion.Date of birthRequiredRequired before completion.GenderBest phone numberRequiredRequired before completion.EmailWeightEnter pounds only, for example 160.Mailing addressRequiredRequired before completion.

Height Required

Use the dropdowns so agents do not have to type height manually.

FeetInches

Feet are required before completion.

CityRequiredRequired before completion.StateRequiredRequired before completion.ZIP code

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