CONTACT FORM SUBMITTED AT: https://mycompletecare.com/contact

NAME: Melody Lugo

EMAIL: melody.m.lugo@gmail.com

COMPANY:

TYPE OF INQUIRY: Other

FACILITY: 	* Prospect Heights
[https://mycompletecare.com/ccprospectheights]

MESSAGE: 
Hello
My mother is currently a patient at the Prospect Heights location. Her
insurance company is asking for a Physician Statement to be filled out
for her short term disability claim. The doctor at Hackensack Hospital
said this should be filled out by the rehab facility. Could you please
provide me with an email address and contact information of a person
that can fill this out for us. Thank you!
