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Bernard D. Fallen MD566 Fashion Avenue, suite 502Manhattan, NY10018Phone: 2127991121Fax: 5163368440Consent for Release of InformationPatients Name: D.O.B. I the above named person, authorize Dr. Bernard
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Bernard D. Raxlen MD is a medical doctor specializing in Lyme disease and other tick-borne illnesses.
Patients receiving treatment or consultation from Bernard D. Raxlen MD may be required to file relevant medical information for insurance or legal purposes.
Patients can fill out the necessary information on bernard d raxlen md forms provided by Bernard D. Raxlen MD's office or healthcare facility.
The purpose of bernard d raxlen md is to document and track the medical treatment and progress of patients under the care of Bernard D. Raxlen MD.
Information such as patient personal details, medical history, current medications, treatment plans, and progress notes must be reported on bernard d raxlen md.
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