From: "Doyle, Briatma"
To: '
Subject: Questionnaire
Date: Mon, 26 Oct 2015 13:37:23 +0000
Attachments: NEW PATIENT FORM.pdf
Inline-Images: image001.png; image002.png; image003.png; image004.png; image005.png
Good morning,
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 Or. 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 on the 2nd Floor in-between York Avenue and the East River.
Thank you,
BRIANNA DOYLE
Surgical Coordinator
Dr. Bernard A. Rawlins
TEL
FAX
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