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Return Completed Forms to: FAX 8664611388 or mail to: Po Box 84068 Lexington, SC 29073 Patient Name: Please call us with any questions: 8036999073 8437571173 Date of Birth: We have received a request

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2. Dial the fax number 8664611388 on your fax machine or computer.
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4. Enter any required information, such as the recipient's name or organization, on the fax cover sheet or in the email subject line.
5. Double-check the fax number and make sure it is entered correctly.
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