EFTA Document EFTA02069569

To: From: Sent: Subject: Dr. Rawlins Mon 10/2612015 8:41:53 PM You will see Dr. Rawlins at 12:30 tomorrow (knowing this is a double booked appointment and you will have to wait) I have filled out the questionnaire as much as I can ...you must fill out the rest. We need answers to the 3 below questions before you go to the appt: I have attached a questionnaire to this email for the patient to please complete prior to his appointment and bring with him to his consultation with Dr. Rawlins on October 27, 2015 at 9:15A along with any relevant radiology imaging and reports related to his spinal issue. I do need to know the following information prior to the appointment: • Leg or arm pain? How long? • Injections? How many? • Pain medication the patient is taking and if he is pain management. We are located at 523 East 72nD Street on the 2' Floor in-between York Avenue and the East River. Thank you, EFTA_R1_00628478 EFTA02069569