| Patient Name | Colby Jur |
|---|---|
| Cell Phone Number | (540) 841-1573 |
| Consent | I agree to receive text messages for this service. I understand that message rates may apply and accept any charges. |
| Status | Complete |
| Entry Date | August 31, 2020 |
| Covid Questions | Please answer the following questions. |
I agree to receive text messages for this service. I understand that message rates may apply and accept any charges.