Re: More Oncoblot Paperwork and Signature Today!

re schedule

On Thu, May 19, 2016 at 11:54 AM, ████████████████████████████████> wrote:

To clarify: do you want me to reschedule your Consultation w/Oncoblot?-you are currently scheduled for a call at 5:45pm today...

On May 19, 2016, at 11:49 AM, jeffrey E. jeevacation@gmail.com wrote:

no time today

On Thu, May 19, 2016 at 10:21 AM, wrote:

I have a quick form you must fill out prior to your consultation today and I need your signature. The signature is for their PMA contract which I need signed and returned BEFORE your consultation. This allows the doctor to freely speak with you about all the alternative therapies that we offer. The $10 for your PMA contract will be added to your visit.

Questions on new form are:

Current Medications:

Medical History:

Allergies to Medication:

Surgical History:

Hospitalizations:

Social History: Tobacco? Marijuana? Alcohol? Caffeine:

Family History: Mother? Father?

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please note

The information contained in this communication is confidential, may be attorney-client privileged, may constitute inside information, and is intended only for the use of the addressee. It is the property of JEE

EFTA R1_00590139
EFTA02051422