Health Information Fax Cover Letter
To: Cardiology Department
Location: Jacksonville, FL 32258
From: [Your Name]
Company: [Your Company Name]
Email: [Your Email]
Date: May 2, 2056
Fax number: (555) 765-4321
Number of Pages:
5 (including this cover letter)
Confidentiality Statement:
The information contained in this facsimile message is legally privileged and confidential information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this facsimile in error, please immediately notify us by telephone and return the original message to us at the above address via the United States Postal Service.
Fax Contents:
Patient Information Sheet
Medical History
Recent Test Results
Treatment Plan
Medication List
Fax Purpose:
The purpose of this fax is to provide the necessary medical information for the ongoing treatment and care of the patient, Jane Miller's. This includes her recent test results, comprehensive medical history, and the current treatment plan as requested by Dr. John Smith for a consultation.
Relevant Notes:
Please ensure that all received documents are added to Jane Miller's medical record.
Follow-up actions: Dr. Smith is requested to review the enclosed documents and contact our office with any recommendations or changes to the treatment plan by July 10, 2054.
Enclosures:
Patient Information Sheet: Jane Miller's demographics and contact information.
Medical History: Complete medical history: surgeries, allergies, chronic conditions.
Recent Test Results: Lab and imaging results from June 30, 2054.
Treatment Plan: The current plan includes medications, therapy, and follow-ups.
Medication List: List of current medications with dosages and instructions.
Best regards,
[Your Name]
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