Claims-Widget – MoverClick

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Form

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Photo

Claim Form

Fastest claim recovery

Secure Order ID:

First and Last Name

Does the item still function safely?

If your item is unsafe to use or function, please discontinue using this item immediately. If a medical device is damaged, please get in touch with the issuing hospital.

Claim Photos

Please send a photo of the damaged area or skip and explain loss below

What are your prefered results?

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1

Form

2

Photo

Claim Form

Fastest claim recovery

Secure Order ID:

First and Last Name

Does the item still function safely?

If your item is unsafe to use or function, please discontinue using this item immediately. If a medical device is damaged, please get in touch with the issuing hospital.

Claim Photos

Please send a photo of the damaged area or skip and explain loss below

What are your prefered results?

The form was sent successfully.

An error occured.

The form was sent successfully.

An error occured.

(952) 474-6683