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