To: Nicole Junkermann From: Sent: 6/21/2017 2:50:51 PM Subject: Fwd: Dr. Merrell's Office- NP Inquiry Checklist for New Patient Inouiries.doc Hi ..can you please fill out this form Dr. Woody Merrell's office needs in order to try and get you Begin forwarded message: From: Candice ANIMIRMINIMMIMI Subject: Dr. Merrell's Office- NP Inquiry Date: June 21, 2017 at 10:49:49 AM EDT To: Good Morning, Attached is a new patient inquiry form. Please fill it out and email it back to me. Thank you in advance! Sincerely, Candice Smith Administrative Assistant to Dr. Woodson Merrell 44 East 67th Street NY, NY 10065 EFTA_R1_00954615 EFTA02219941