EFTA00540398Set 9
2018-03-292p780w
ELECTRONICALLY TO A PERSONAL HEALTH RECORD OR E-MAIL
ACCOUNT
I hereby authorize Quest Diagnostics to electronically send the results of laboratory tests performed on me by
Quest Diagnostics from ... receipt of this Authorization,
however if you do not complete this Authorization Quest Diagnostics will not honor your request that we
send your information to the Electronic Account identified
https://www.justice.gov/epstein/files/DataSet%209/EFTA00540398.pdf