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Timothy W. Casarez, MD., FACC
David A. Ferry, MD., FACC
Nancy Kim, MD., FACC
Frederic Leong, MD., FACC
Jeffrey A. Wong, MD., FACC
DATE:
TO: PEDIATRIC CARDIOLOGY MEDICAL ASSOCIATES
FAX #’S: ENCINO, SANTA CLARITA, LANCASTER:
Fax (818) 784-1531 • Tel (818) 784-6269
THOUSAND OAKS:
Fax (805) 497-0864 • Tel (805) 497-7214
FROM:
PATIENT:
TOTAL NUMBER OF PAGES INCLUDING COVER SHEET:
FAX COVER LETTER
Encino • Thousand Oaks • Santa Clarita • Lancaster • www.cardiologyforkids.com
STATEMENT OF CONFIDENTIALITY:
THE DOCUMENT ACCOMPANING THIS COPY TRANSMISSION CONTAINS CONFIDENTIAL INFORMATION
BELONGING TO THE SENDER WHICH IS LEGALLY PRIVILEGED. THE INFORMATION IS INTENED ONLY FOR THE
USE OF THE INDIVIDUAL OR INTENDED NAME ABOVE. IF YOU ARE NOT THE INTENDED RECIPIENT, YOU ARE
HEREBY NOTIFIED THAT ANY DISCLOSURE, COPYING, DISTRIBUTION, OR TAKING OF ANY ACTION IN
RELIANCE ON THE CONTENTS OF THIS COPIED INFO IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS
IN ERROR PLEASE CALL US AT 818-784-6269
Welcome to our cardiology practice! In order to save time, please fill out our new patient registration forms
and fax them to our office or bring them with you to your child’s appointment. For your convenience, you
may use this page as the fax cover letter and please do not hesitate to call our office with any questions.