To: From: Sent Tue 9/25/2018 7:39:20 PM Subject: Re: Credit Card Form - Dr. Paduch yes On Tue, Sep 25, 2018 at 3:06 PM, wrote: shall i fill out the cc form for your appointment tomorrow w. Dr. Paduch? Begin forwarded message: From: Crismely Ovalle Subject: Credit Card Form - Dr. Paduch Date: Se tember 25, 2018 at 2:44:13 PM EDT To: Hi MI 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 68`" Street. Starr 924A New York, New York 10065 please note EFTA_R1_0 1053662 EFTA02258499

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