Medical History Update Fax Sheet

Medical History Update Fax Sheet

FAX

To: [Recipient's Name]
Recipient's Address:
[Recipient's Address]

Date: January 20, 2055

Re: Medical History Update for [Patient's Name]
Fax No.: 123-456-7890

  • Urgent

  • To Review

  • Please Respond


Message

Dear [Recipient's Name],

We are reaching out to provide an update regarding the medical history of our shared patient. Due to recent findings in their annual physical examination, there have been significant revisions made to their medical records.

Patient Information:

  • Name: [Patient's Name]

  • Date of Birth: [Patient's Date of Birth]

  • Primary Care Physician: [Physician's Name]

Updated Medical History Includes:

  • Recent Medical Conditions

  • Current Medications

  • Allergies

  • Surgeries (if applicable)

Please incorporate this information into the patient's records as needed. For further details or clarification, kindly contact us at [Your Company Email]. Thank you for your attention to this matter.

Best Regards,

[Your Name]

[Your Designation]

[Your Company Name]

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