Your Practice Name
123 Your Street
Yourtown, ON 12345
1 January 2011
Mr. John Doe
100 Deere St.
Yourtown, ON 12345
Dear John,
We are in the process of updating your file and would like to verify the information we currently have.
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Home Phone |
123-4567 |
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Work Phone |
987-6543 |
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Employer |
Business Enterprises, Inc. 123 Maple Dr. Yourtown, ON 12345 |
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Primary Insurance |
Mutual Benefits |
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Remaining Benefit |
$265.00 |
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Last Visit Date |
2 February 2010 |
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Last Payment |
$125.00 12 March 2010 |
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Account Balance |
$0.00 |
If you see any errors in the above would you please call us so that we can insure that our records are correct.
Sincerely,
Dennis D. Davis, DDS