Sangre de Cristo Internal Medicine

www.sdcim.com, fax 843-627-4390

Medical Records Invoice Number:

Date:            

To Whom it may concern,

We are in receipt of your medical records request for:

           Name: 

           DOB: 

           Last 4 ssn:

           Telephone confirmation date/name:

We have processed the request and the data file size is:

The cost for the file is:

Please process payment for this request on our secure website (www.sdcim.com) via the online bill pay link checking out with the email address below (which you provided in your request authorization forms and/or confirmed at our confirmation phone call, receipt will be sent to this email address). Your payment serves as authorization to send medical records via either of the modalities below.

           Your email:

Once payment is received, we will return the authorized records via encrypted email to the address above.

Alternatively, if your organization has a secure upload site, please reply to this email with logon credentials and we will upload your records there.

 Sincerely, Sangre de Cristo Internal Medicine