VERY IMPORTANT!

THE TESTS THAT HAVE BEEN ORDERED ARE BEING PERFORMED TO ENSURE THAT YOU ARE AT MININMAL RISK FOR SURGERY. ONLY THE TESTS CHECKED ON YOUR PRESCRIPTION ARE NECESSARY.

• IT WILL BE YOUR RESPONSIBILITY TO MAKE SURE ALL TESTING IS DONE IN A FACILITY APPROVED BY YOUR INSURANCE PLAN AND AUTHORIZATION IS OBTAINED PRIOR TO YOUR TESTING DATE.

• IF YOUR TESTS ARE NOT PERFORMED AT THE HOSPITAL, IT IS YOUR RESPONSIBILITY TO HAVE ALL RESULTS FORWARDED TO:

Dr. Ibrahim/Dr. Strain

350 Engle Street , 2 East

Englewood , NJ 07631

Phone: 201-227-5533

Fax: 201-227-5537

• TEST RESULTS MUST BE AT THE CENTER AT LEAST TWO WEEKS BEFORE YOU ARE SCHEDULED TO SIGN YOUR CONSENTS FOR SURGERY.

LACK OF COMPLIANCE IN DOING THIS COULD MEAN A DELAY OR CANCELLATION OF YOUR SURGERY.