EFTA02051421.pdf

To: From: Jeffrey E. Sent Thur 5/19/2016 6:11:52 PM Subject 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. [email protected]> wrote: no time today On Thu, May 19, 2016 at 10:21 AM, wrote: 1 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: Hopitalizations: Social History: Tobacco? Marijuana? Alcohol? Caffeine: Family History: Mother? Father? please note The information contained in this communication is confidential, may be attorney-client privileged, may EFTA_R1_00590138 EFTA02051421 constitute inside information, and is intended only for the use of the addressee. It is the property of JEE Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify us immediately by return e-mail or by e-mail to [email protected], and destroy this communication and all copies thereof, including all attachments. copyright -all rights reserved 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 Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify us immediately by return e-mail or by e-mail to jeevacationAgmail.com, and destroy this communication and all copies thereof, including all attachments. copyright -all rights reserved EFTA_R1_00590139 EFTA02051422