Julie A. Griffith M.D., M.S. B.C.I.P. Energy Health Center, Inc. 5 Bon Air Rd, Suite D219 Larkspur, CA 94939 Telephone (415) 925-1616 Facsimile (415) 962-1303 MEDICATIONS/SUPPLEMENTS Patient: DOB: Wt. KG. Pharmacy: Phone: Mg Mg / / Name Mg Mg PM/ PM/ /cc /cc AM B MM L MA D BT AM B MM L MA D BT Supplements Medication
Julie A. Griffith M.D., M.S. B.C.I.P. Energy Health Center, Inc. 5 Bon Air Rd, Suite D219 Larkspur, CA 94939 Telephone (415) 925-1616 Facsimile (415) 962-1303 MEDICATIONS/SUPPLEMENTS Patient: DOB: Wt. KG. Pharmacy: Phone: Name Mg / Mg /cc AM B MM L MA D PM/ BT Mg / Mg /cc AM B MM L MA D PM/ BT Medication Supplements
Welcome_Package_Pediatric_2018.docx