600 N 21st St, Superior, WI 54880 • Phone: 715-394-6677 • woodsandwater@medicalcenter.

com

August 25, 2020

Antonio Columbus
2086 Smith Avenue
Chicago, IL 60624

Dear Dr. Columbus:

We are pleased to provided professional services for you at no charge. If you have health
insurance, we would appreciate assignment of benefits for the covered services. We will be
glad to process your claim for you.

If laboratory and x-ray services are performed outside this clinic, please check with the
providers at the time of service regarding their billing procedures.

Thank you for allowing us to participate in your health care.

Sincerely,

Mark Harfer, MD
Internal Medicine

amm