Pain Consultants of the Rockies, PC

903A South Greeley Highway, Cheyenne, WY  82007
307-633-8100  Fax: 307-633-8108
 


Patient Appointment Card

 

Date appt. made _________________________________________   By _______________________

PCR - P.O. Box 20270, Cheyenne, WY  82003

(307) 633-8100

Name _____________________________________________________________________________     

  

Your appointment is on  ______________________________________________________________

 

Mailed ___________________________________    Given In Person _________________________                                                         Date                                                                                                          Date

 

This time is set aside for you to visit with your provider.   If you cannot keep this appointment, please notify our office at least 24 hours in advance so another person can be scheduled in this time period. 

Thank you.

 

 

 

 

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