Photo ID Cards

Step 2

Please complete the following information and submit your electronic signature.

Electronic Signature

Under penalty of perjury, I am the person whose name appears here. I release the Medical Offices of Sona Patel M.D. Inc., its trustees, employees and agents from all liability or legal responsibility arising from the disclosure of these records or information.

By typing my name here and entering today's date for verification, I intend to give my electronic signature.