[Your Name] [Your Address] [City, State ZIP] [Phone Number] [Email Address] [Date]

Cigna Health Insurance Claims Review Department [Claims Address if known] Re: Request for Reimbursement — LANAP (Laser Assisted New Attachment Procedure) Patient: [Your Name] Policy Number: [Policy Number] Claim Number: [If available]

To Whom It May Concern,

I am writing to request reimbursement for the LANAP procedure I received for treatment of periodontal disease. LANAP is an FDA‑approved, evidence‑based laser protocol for managing moderate to severe periodontitis. My treating periodontist recommended this approach as the most appropriate and conservative option given my medical history and clinical presentation.

My periodontal disease has a clear connection to both genetic predisposition and my medical history of diabetes. Genetic factors can influence the strength of the immune response, the composition of oral microbiota, and susceptibility to inflammatory bone loss around teeth. In persons with a genetic predisposition, periodontal disease can progress more rapidly and be less responsive to routine measures alone. Diabetes—particularly when blood glucose is elevated—exacerbates periodontal inflammation and impairs healing by altering immune function, blood flow, and collagen metabolism. Conversely, active periodontal disease can further impair glycemic control, creating a bidirectional relationship between diabetes and periodontitis. Given these interactions, definitive periodontal treatment is medically necessary to reduce ongoing inflammation, protect oral function, and help maintain systemic health.

I have taken significant, sustained steps to manage my diabetes and overall health. I have lost 55 pounds and have achieved and maintained an A1C of 4.7. I am fully committed to controlling my medical risk factors and following preventive care recommendations. By pursuing LANAP, I am acting proactively to prevent further oral and systemic complications that could lead to more extensive—and more costly—medical and dental interventions in the future.

LANAP is less invasive than traditional flap surgery, preserves bone and soft tissue, and is supported by clinical studies showing improved outcomes in appropriate patients. For my situation—periodontitis influenced by genetic susceptibility and diabetes—LANAP was recommended by my periodontist as a medically necessary treatment to halt disease progression and support long‑term oral and systemic health.

Please find attached the operative report, itemized billing, relevant clinical notes from my periodontist documenting diagnosis and medical necessity, and supporting literature references regarding the FDA approval and clinical indications for LANAP. I respectfully request that Cigna reimburse me for this needed procedure under the terms of my policy.

Thank you for your prompt attention to this request. If additional documentation or clarification is required, please contact me at the number above or have a representative contact my periodontist, Dr. [Name], at [Periodontist Phone] or [Periodontist Address].

Sincerely,

[Your Name]

Client Questionnaire — Portrait Session for Women 50+

Thank you for choosing Schexnayder Photography. This questionnaire helps me design a portrait session that reflects your personality, comfort level, and vision. Please answer as fully as you like — there are no right or wrong answers.

Contact & Session Basics

  • Full name:

  • Preferred name/nickname:

  • Email:

  • Phone:

  • Best way/time to contact you:

  • Session date (if scheduled) or preferred timeframe:

  • Session location preference: studio / on-location / home / outdoor (please specify a place if you have one)

  • Who will be attending the session with you? (spouse/partner, friend, adult child, pets, makeup stylist, etc.)

About You

  • Age range (optional): 50–59 / 60–69 / 70+

  • How would you describe your personality in a few words? (e.g., warm, energetic, calm, playful, elegant)

  • What are three words you want your photos to convey?

  • How do you spend most of your time? (career, hobbies, volunteer work, grandparenting, travel, etc.)

  • Are there any personal stories, milestones, or achievements you’d like to celebrate with these portraits?

Style & Vision

  • What is the primary purpose of this session? (personal portraits, updated professional headshot, gift, milestone celebration, social media, family heirloom, etc.)

  • Do you prefer classic/clean, lifestyle/natural, artistic/creative, glamorous, casual, or mixed styles?

  • Which look feels most “you” for this session? (e.g., natural makeup and relaxed clothing, full hair/makeup and dressy outfits, bold fashion-forward looks)

  • Are there any photographers, images, or styles you love? (describe or attach sample images if possible)

  • Colors and backgrounds you prefer (light/white, neutral, warm tones, deep/black, outdoor/nature, architectural/urban):

  • Are there any looks or styles you want to avoid?

Wardrobe & Styling

  • How many outfit changes would you like? (1 / 2 / 3+)

  • Types of outfits you’re considering (casual, dressy, business, dresses, separates, jeans, layers, statement pieces, etc.):

  • Favorite clothing colors or patterns:

  • Any colors or clothing styles you dislike or that you prefer not to wear?

  • Do you plan to bring accessories? (jewelry, hats, scarves, glasses, scarves, shawls, belts — list specifics)

  • Would you like help with wardrobe selection or packing list suggestions? (yes / no)

  • Will you want hair and makeup on location or pre-done? (I can recommend stylists)

Comfort & Posing

  • Are you comfortable being directed in poses, or do you prefer more candid/natural movement?

  • Any parts of your body you want to emphasize or minimize? (face, eyes, hands, chin, posture, etc.)

  • Do you have any physical limitations or injuries I should know about (mobility issues, balance, arthritis, pain with certain positions)?

  • Do you enjoy close-up portraits, waist-up, full-length, or a mix?

  • How do you feel about showing your smile vs. a more serious/expression-driven portrait?

  • Any gestures or poses you love (hands on hips, sitting, leaning, walking, hugging yourself)?

Hair, Makeup & Skin Concerns

  • Do you have any skin concerns you’d like me/stylist to be aware of? (rosacea, hyperpigmentation, recent skin treatments)

  • Any recent injectables or cosmetic procedures I should know about and the date?

  • Do you wear glasses for most photos? (Yes — I’d like to wear them / Yes — I prefer no glasses / No)

  • Do you want retouching for skin smoothing, wrinkles reduction, blemish removal, or natural/light retouch only?

Makeup Preferences

  • Makeup style preference: natural, polished, glamorous, minimal, none

  • Areas to focus on: eyes, lips, complexion, contouring, minimizing shine

  • Allergies or product sensitivities:

Props & Personal Items

  • Would you like to include personal items or meaningful props? (books, instruments, family heirlooms, hats, scarves, plants, sports equipment)

  • Any pets to include? (type, size, breed, temperament)

  • Do you want photos with a spouse/partner or family members? If yes, list names and relationship.

Lighting & Location Details

  • Indoor studio or outdoor location preference?

  • If outdoor: do you prefer garden/nature, urban/architectural, beach/river, residential neighborhood?

  • Any specific location that is meaningful to you? (home, a park, café, a place you worked, etc.)

  • Are you sensitive to