EFTA00482226.pdf

From: To: "Dr. Darius Paduch" Cc: Bella Klein Subject: Re: Credit Card Form - Dr. Paduch Date: Tue, 25 Sep 2018 19:45:05 +0000 Attachments: Scan_456.pdf HI Cris! Please see attached signed CC form...I did not fill in the amount as we don't know it yet...but Jeffrey confirmed it was OK for me to provide you the information. On Sep 25, 2018, at 2:44 PM, Crismely Ovalle < > wrote: Hi In case it is easier, attached is our credit card form. Feel free to email or fax it back to me tomorrow. Our fax number is Notify me if you will fax it over, so I can look out for it. Thank you, Cris Ovalle Sr.Medical Secretary Weill Cornell Medicine Department of Urology 525 East 68th Street, Starr 924A New York, New York 10065 Ti FM <Untitled.PDF - Adobe Acrobat Pro.pdf> EFTA00482226