EFTA00504242

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I have paperwork you must complete for tomorrows appointment w/Dr. = Lighvani. I have filled out all I can=E2=80=A6there are personal = questions for you as well as your signature is needed in areas=E2=80=A6I = will leave on the DR table for you=E2=80=A6The doctor asks you please = bring this paperwork with you to your appointment. I have a copy of the = front and back of your insurance card attached=E2=80=A6.they will not = let me prepay your copay=E2=80=A6please have a CC with you to pay the = $30!! EFTA00504242

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