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Align Medical is dedicated to providing gold standard, industry leading medical care and improving outcomes for all patients throughout the DFW metroplex

Work or Personal Injury?

Contact us Today!

972-885-1700
(469) 669-8922
scheduling@alignmedmgt.com

location:

Over 10+ locations in the dfw area

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First Name*

Last Name*

Date Of Birth*

Gender*

Phone Number*

Email*

Date Of Injury*

What Type Of Injury?*

Did you report the injury immediately?*

Did you have any attorney representing you?*

Which insurance carrier do you have?*

Name of employer*

Please describe the injury: *

Please list the injured body parts below: *

Contact Us

Work or Personal Injury?

Contact us Today!

location:

Over 10+ locations in the dfw area

Contact Us

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