*The above patient(s) are now attending our clinic. As we are a paperless office please forward a summary or a disc of their medical records. OR email to email@example.com. Per, The College of Physicians and
*Surgeons PLEASE DO NOT SEND THE ORIGINAL COPIES.
I understand that this service is not recognized as “medically required” and is not covered by the Medical Services Plan. I realize that there may be a charge for this service and you may bill me accordingly.