Dac Message 1112

<p><strong>Medical Estimate or Receipt or Bill</strong></p> <p>Please make sure your document includes:</p> <ul> <li>Your name.</li> <li>Your home address listed on your application.</li> <li>The name of your medical provider.</li> <li>The phone number of the service provider.</li> <li>The date of the medical injury or illness.</li> <li>Your type of coverage.</li> <li>A brief explanation from your medical provider that the injury was caused by the disaster.</li> </ul>