Free Medical History Update Fax Sheet Template
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
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Urgent
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To Review
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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:
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Name: [Patient's Name]
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Date of Birth: [Patient's Date of Birth]
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Primary Care Physician: [Physician's Name]
Updated Medical History Includes:
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Recent Medical Conditions
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Current Medications
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Allergies
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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]
