Once we receive your form, the confidential information will be reviewed and a medical staff member will contact you to verify all information and schedule your cancer screening.
CONFIDENTIALITY NOTICE
The documents accompanying this email or telecopy transmission contain confidential information. The information is intended only for use by the individuals or entity named above. If you are not the intended recipient, you are notified that any disclosure, copying, distribution, or taking of any action in reliance on the contents of this emailed or telecopied information is not permissible. If you have received this email or telecopy in error, please immediately notify us by telephone at 260-482-8001 to arrange for the return of the original documents. Thank you.
