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About
Testimonials
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Spotlight
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Partners
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MARKETING MATERIALS REQUEST FORM

Please enter the requested information and click on the “Submit” button. The requested materials will be sent via US Mail at no cost to you.

ChiroHealthUSA is regulated as a Discount Medical Plan Organization (DMPO) in many states, which means specific advertising rules apply. The assets below are provided free of charge for your use, but may not be altered or supplemented in any way.

ChiroHealthUSA Brochures

Available in English and Spanish. Be sure to select the correct state when requesting.

Personalized QR Code Labels

Patients may now sign up for ChiroHealthUSA themselves by scanning a unique QR code in your clinic.

Countertop Standee

Place on your clinic front desk to remind patients that your practice is a ChiroHealthUSA provider.

Door
Decal

Place on your clinic front door to remind patients that your practice is a ChiroHealthUSA provider.

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All fields are required.

DOCTOR's Name*

First Last

Clinic Name*

Clinic Phone*

DOCTOR's Email*

Enter Email Confirm Email

CONFIRM YOUR ADDRESS

To ensure we have the most up-to-date information, please provide your preferred mailing address for item delivery.

Address*

Street Address City State / Province / Region ZIP / Postal Code

CHOOSE YOUR MATERIALS

Which assets would you like to receive?*

ChiroHealthUSA Brochures

Personalized QR Code Labels

Countertop Standee

Door Decal

Please select the type of brochures you need*

Standard

Oregon

Utah

Please select the brochure languages you need*

English

Spanish

TERMS OF USE

Due to DMPO restrictions, you may only use marketing materials provided by ChiroHealthUSA. The QR code may not be used for any purposes other than those approved by ChiroHealthUSA.

Acknowledgment*

Please click to acknowledge the Terms of Use.

Acknowledged

Disclosures

Most States
OREGON RESIDENTS

This discount medical plan is NOT insurance, a health insurance policy, or a qualified health plan under the Affordable Care Act. The plan only provides discounts on medical services and equipment offered by providers who have agreed to participate in the plan. The range of discounts for medical services and equipment offered under the plan will vary depending on the type of provider and medical services and equipment received. The plan does not make and is prohibited from making payments to providers for medical services or equipment received under the plan. The member is obligated to pay for all discounted medical services and equipment received under the plan, but will receive a discount on certain identified medical services and equipment from providers participating in the plan. The Discount Medical Plan Organization/Discount Plan Organization is Perfectly Protected Practice, Inc., 1307 Airport Rd. N, Suite 1A, Flowood, MS 39232, membership@chirohealthusa.com. You may call 1-888-719-9990 for more information and to request a list of program providers and the providers’ city, state and specialty, located in your service area. You may also search for participating providers at www.perfectlyprotectedpractice.com. The plan is subject to fees, requirements, and restrictions as specified in the membership agreement and includes a 30-day cancellation provision. Note to MA consumers: The plan is not insurance coverage and does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00. Not available for sale in the state of Washington.

If you cancel within the first 30 days after the effective date, you are entitled to a refund of membership fees paid. If you cancel after the first 30 days, you are eligible for a pro-rata refund of membership fees paid. If we cancel your membership for any reason, other than non-payment, you are eligible for a pro-rata refund of membership fees paid. Refunds will be issued within 30 days of cancellation. You may cancel by contacting us at 1-888-719-9990 or membership@chirohealthusa.com or Perfectly Protected Practice, Inc., 1307 Airport Rd. N, Suite 1A, Flowood, MS 39232. Members receive at least 5% off usual and customary rates. Perfectly Protected Practice, Inc. does not guarantee the quality of the medical services or equipment offered by individual providers.

This discount medical plan is NOT insurance, a health insurance policy, or a qualified health plan under the Affordable Care Act. The plan only provides discounts on medical services and equipment offered by providers who have agreed to participate in the plan. The range of discounts for medical services and equipment offered under the plan will vary depending on the type of provider and medical services and equipment received. The plan does not make and is prohibited from making payments to providers for medical services or equipment received under the plan. The member is obligated to pay for all discounted medical services and equipment received under the plan, but will receive a discount on certain identified medical services and equipment from providers participating in the plan. The plan is subject to fees, requirements, and restrictions as specified in the membership agreement and includes a 30-day cancellation provision. Note to MA consumers: The plan is not insurance coverage and does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00. Not available for sale in the state of Washington. The Discount Medical Plan Organization/Discount Plan Organization is Perfectly Protected Practice, Inc. (d/b/a ChiroHealthUSA), 1307 Airport Rd. N, Suite 1A, Flowood, MS 39232, membership@chirohealthusa.com. You may call 1-888-719-9990 for more information and to request a list of program providers and the providers’ city, state and specialty, located in your service area. You may also search for participating providers at www.perfectlyprotectedpractice.com.

If you cancel within the first 30 days after the effective date, you are entitled to a refund of membership fees paid. If you cancel after the first 30 days, you are eligible for a pro-rata refund of membership fees paid. If we cancel your membership for any reason, other than non-payment, you are eligible for a pro-rata refund of membership fees paid. Refunds will be issued within 30 days of cancellation. You may cancel by contacting us at 1-888-719- 9990 or membership@chirohealthusa.com or Perfectly Protected Practice, Inc., 1307 Airport Rd. N, Suite 1A, Flowood, MS 39232. Members receive at least 5% off usual and customary rates.

1307 Airport Rd N Ste 1A, Flowood, MS 39232 ● Phone: (888) 719-9990 ● Fax: (888) 685-2220 ● info@chirohealthusa.com
Office Hours: Monday – Friday 8:00 AM – 4:30 PM CST

1307 Airport Rd N Ste 1A, Flowood, MS 39232 ● info@chirohealthusa.com
Phone: (888) 719-9990 ● Fax: (888) 685-2220
Office Hours: Monday – Friday 8:00 AM – 4:30 PM CST

1307 Airport Rd N Ste 1A, Flowood, MS 39232
info@chirohealthusa.com
Phone: (888) 719-9990 ● Fax: (888) 685-2220

Office Hours:
Monday – Friday 8:00 AM – 4:30 PM CST

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MARKETING MATERIALS REQUEST FORM

ChiroHealthUSA Brochures

Personalized QR Code Labels

Countertop Standee

DoorDecal

CONFIRM YOUR ADDRESS

CHOOSE YOUR MATERIALS

TERMS OF USE

Door
Decal