fax cover sheet - intragapgi.com
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![Page 1: FAX COVER SHEET - intragapgi.com](https://reader031.vdocument.in/reader031/viewer/2022013018/61d14a76c18e605c860408fe/html5/thumbnails/1.jpg)
William Austin, MD Scott Cornella, MD Henry Mixon, MD Blake Scott, MD
David Barry, MD Sean Harris, MD Daniel Murphy, MD Brian Smith, MD
Brent Cengia, MD Robert Holmes, MD Laura Patwa, MD John Sweeney, MD
Christopher Connolley, MD Ryan McKimmie, MD Randy Peters, MD David Wood, MD
Phone: (336) 448-2427 ⚫ www.gapgi.com ⚫ Fax: (336) 765-2869
Providing compassionate, patient-centered gastroenterology care to the greater Triad area
FAX COVER SHEET DATE: ____________________ # OF PAGES (INCLUDING COVER): ___________________
TO: _________________________________________ FAX #: ___________________
FROM: _________________________________________________________________
RE: ____________________________________________________________________
NOTES/SPECIAL INSTRUCTIONS:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
If copies received are illegible, please call us at (336) 448-2427 and ask for _______________________.
This facsimile transmission is intended for the use of the addressee named above only. It may contain information that is proprietary, subject to attorney/client privilege or medical confidentiality, or otherwise confidential. If you are not the intended recipient of this communication, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by telephone so that we can arrange for return of the communication at no cost to you.
Revised 3/2020