EFTA Document EFTA02041307

To: From: Sent Subject Re: New Patient Form from Tue 9/27/2016 3:06:11 PM Hi, Ok I understood Ornparineito c iPhone 27 cern. 2016 r., a 10:17, <O> Hantican(a): Hi ...Jcffrcv would like you to see as well on Oct. 6th...I have called his office to make your appointments but YOU must first fill out their new patient inquiry form...it will be emailed to you directly from his office...please be on the look out for this email and fill it out as soon as possible. The doctor must then look over your form and then I can make the appointment... Please let me know once you have emailed the form back to the doctors office so I can call them... confirm back now please so I know you have received and read.. Thanks! EFTA_R1_00568683 EFTA02041307