EFTA02514228

From: Lesley Groff Sent: Wednesday, January 21, 2015 8:01 PM To: Jeffrey Epstein; Karyna Shuliak Subject: Forms for Dr. Kline appointment tomorrow I am sending you 2 forms that I have filled out but need your signature =or the Dr. Kline appt tomorrow at 8:40am. One is "Receipt of Notice =f Privacy Practices Written Acknowledgement Form" ...the other is a =93Patient Request for Email Communications" I am not sure if you =ant to sign either... Karyna, can you please print for Jeffrey and let him have a look at =hem...if he wants to sign them, he can either take the originals with =im to the appointment tomorrow...or maybe better, you can fax them to =r. Kline's office at (you can always scan and email to =e and I can fax them if you prefer) <?xml version=.0" encoding=TF-8"?> <!DOCTYPE plist PUBLIC "-//Apple//DTD PLIST 1.0//EN" "http://www.apple.com/DTDs/PropertyList-1.O.dtd"> <plist version=.0"> <clict> <key>conversation-idgkey> <integer>127290</integer> <key>date-last-viewed</key> <integer>0</integer> <key>date-received</key> <integer>1421870453</integer> <key>flags</key> <integer>8590195713</integer> <key>gmail-label-ids</key> <array> <integer>6</integer> <integer>2</integer> </array> <key>remote-id</key> <string>475224</string> </dict> </plist> 1 EFTA_R1_01647696 EFTA02514228