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If you haven’t heard UNM Truman Health Services is now a level 3 Patient Centered Medical Home (PCMH)! What does that mean for you? You will continue to receive the highest quality of care and service at every visit. This widely recognized symbol of quality shows the hard work and dedication UNM Truman Health Services provides to our patients.
UNM Truman Health Services and the UNM Medical Group are now accredited by the Accreditation Association for Ambulatory Health Care, Inc. Be sure to take a moment and congratulate our providers and staff for all of their hard work to make UNM THS the best place for your healthcare.
WHAT’S INSIDE Page 10
Get Your Flu Shot
Page 11
World AIDS Day Events Thank You
Page 12
National Black HIV/AIDS Awareness Day
Page 2
Dear Patient Dates to Remember
Page 3 Page 4
Healthy Habits for the New Year
Page 5 Page 6 Page 7
Stop Smoking Sessions Transportation Cancellation Policy
Page 14
Pharmacy Selection
Page 8 Page 9
Have You Heard Notice of Privacy Policy
Page 15
Truman Times Classified
New Year’s Resolution
SAGE
The Real Valentine’s Day
Truman Health Services | 801 Encino Place NE | Building F| Albuquerque, NM 87102| 505-272-1312 www.unmtruman.com
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To Help Us Keep Your Records Up-To-Date
Dear Patient, Happy New Year and welcome to 2015! We are excited about the new happenings here at UNM Truman Health Services. We are going to start the new year by going back in time. Thirty years to be exact. July 2015, is the 30th anniversary of Truman Health Services and we are excited to celebrate this milestone. Fast-forward and our new year begins with building construction and expansion. In 2014 UNM THS grew exponentially and we are now able to expand our clinic space to provide you with increased service opportunities. We ask that you please be patient with us as we are in the middle of construction. During this time we will continue to provide the same high-quality services . AT UNM THS we are committed to providing our patients with the highest quality of care and compassion and respect for human dignity We love feedback so please feel free to share your comments on this newsletter or any of the services provided here at UNM Truman Health Services. Send your feedback to THSInfo@unmmg.org. Happy New Year! UNM Truman Staff and Faculty
Please be sure we have your most recent insurance card on file. Let the front desk staff know if your insurance has changed.
If you have an emergency or urgent care visit outside of the UNM system, please fill out a Release of Information form while you are still there. This will allow the Truman care team access to any notes taken during your visit. Have the information faxed to 505-272-2240.
Did you get a new phone? We need to know. If you doctor needs to cancel or change your appointment, or contact you for any reason, we will send a letter to your home if we try calling you two times with no response. Also, if we leave a message asking you to call us back, please be sure to do so, the information may be important.
Have a new address? We would like to know that too! Sometimes we have to mail information to you and we want to be sure it gets in your hands. If you have any questions about the information we need be sure to ask the front desk after your appointment.
Important Dates to Remember UNM Truman Health Services offices will be closed: January 1, 2015, we will reopen on January 2, 2015
January 19, 2014: UNM Truman Health Services offices will be closed: Martin Luther King, Jr. Day, we will reopen on January 20, 2015 February 7, 2015: Nation Black HIV/AIDS Awareness Day
Did you know 20 minutes after you stop smoking your blood pressure goes down; 8 hours after you stop smoking the carbon monoxide levels in your blood return to normal; 24 hours after your stop smoking your chances of a heart attack decrease; 2 weeks to 3 months your circulation and lung capacity improve by 30%; 5 years after you stop smoking your stroke risk is reduced to non-smoker levels; 10 years after you stop smoking your risk of dying from lung cancer is about half of that of a current smoker!
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Healthy Habits for the New Year -Patrick West, RD, LD At the New Year and we may be thinking of making some changes in our life and it is common to focus on our food consumption and physical activity. We constantly hear how what we eat and how much physical activity we have has a significant impact on our health. One thing that will lead to an understanding of our health and what we need to do is to become aware of what our bodies are telling us. Find a way to stop and listen to your body. Believe it or not, our bodies tell us more than we thing they do. Awareness helps us begin to calm our mind and helps to bring our body’s functions back into balance. Consider incorporating a physical awareness into your healthy changes. These practices can be as simple as breathing exercises, meditation, prayer to more involved practices of yoga and tai chi, but we can use any practice that helps bring us back to our center. Many traditions both in the east and west have awareness as the base of a healthy lifestyle. With this great foundation of awareness, moving on to other lifestyle changes is possible. Start out slow with the idea you want to make sustainable changes is a good way to approach any lifestyle changes. Slowly add simple, easily attainable physical activity goals each week like:
Using the stairs when possible. Parking further away from the store. Taking short 10-20 minute walks whenever possible. Doing physical activity you enjoy. -Sports -Dancing -Walking groups with friends
We can start slowly making simple changes to our food choices as well.
Slowly replace refined grains with whole ones. Add vegetables to your meals or make your veggie portions larger. Gradually reduce meat intake to smaller portions. Gradually reduce dairy and egg intake. Add more foods from the legume family like beans, lentils, miso, & legume sprouts. Gradually decrease poor quality fats such as common vegetable, canola, soy, corn oils, margarines, tub spreads and incorporate fats from unrefined and whole sources such as nuts, seeds, and unrefined oils and fats such as extra virgin olive oil, sesame, or butter.
By making these small and easy changes we can see great results within weeks,. Keep in mind true healing and health can take months or even years. Staying away from a quick and easy diet mentality to a slow and steady lifestyle change based in awareness practices may be a more successful way of approaching our health. Awareness comes from being more accepting of ourselves and understanding we may stray from a healthy lifestyle from time-to-time. Making these changes will help us meet our goal of having a healthy, lasting relationship with ourselves. Best wishes to all in this new year!
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How to Succeed With a New Year’s Resolution -by Adam Metcalf, LISW Example: I want to improve intimacy in my relationship Step 1-Understand your goal. Identify your goal and what motivates you to want to achieve it. Identify 5 positive reasons you want to change (try to avoid negative thoughts). Example: My goal is to have more positive intimacy with my significant other. I want to do this because I am more satisfied with my romantic relationship when I have sex at least 2-3 times per week, I like how I feel when my significant other and I connect intimately, I enjoy sex, and I enjoy pleasing my partner. Step 2-Identify barriers to reaching your goal and brainstorm solutions. Example: I rarely want to have sex when I don’t feel connected to my significant other. Solutions: communicate this to your significant other and schedule time together to enjoy activities and have fun conversation. Just make sure that this sometimes leads to sex. Example: I feel my significant other doesn’t want to have sex with me because I am living with HIV or they have shame about sex. Solutions: openly communicate this concern with your significant other and problem solve. Seek peer support or professional help if needed to uncover solutions (i.e., peer support group, sex workshops, nurse, physician, and/or couple’s counseling). Example: I am always distracted by getting online or using phone apps to find anonymous sex. Solution: Avoid those services and identify your triggers for using them. Choose only to have sex with your significant other, or if in a negotiated open relationship, with those you already have a personal connection with. Compulsion for anonymous sex with negative consequences can sometimes indicate problems trusting in genuine intimacy, problems regulating emotions, or unrealistic fantasies about sex. These issues may indicate a need for individual counseling. Step 3- Brainstorm ways to reduce the amount of energy it takes to begin your desired behavior . Example: Couples often have a hard time identifying when both partners are interested in having sex. Develop an agreed upon clear communication/behavior plan so that everyone is aware and on the same page that “it’s on!” Step 4- Make it a habit: It takes roughly three weeks to make a new behavior stick. Set a small, specific, measureable and achievable goal, keep track of your progress in a notebook or calendar, and tell people about your goal. If you miss a day, make it up. Example: I am going to give affection (hugs and kisses) and talk to my significant other for at least 10 minutes every day when they get home from work.
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Step 5- Re-evaluate, don’t just stop! If you find yourself losing motivation or getting off track don’t just stop, re-evaluate your goal. Ask yourself: ‘Why am I not motivated anymore? Is it because my reasons for changing have changed or because the specific goal I’ve set doesn’t work?’ Set a new goal and/or enlist help. Example: I am getting bored with our sex life. Experiment with ways to connect with your significant other in new ways. Step 6-Remember the laws of Physics: A body at rest stays at rest and a body in motion stays in motion unless acted upon by a force. YOU ARE THAT FORCE, NOTHING WILL CHANGE UNLESS YOU COMMIT TO ACT TO CHANGE IT. Step 7-PRACTICE GRATITUDE. Positive things happen when you practice gratitude and give positive feedback to your significant other.
Stop Smoking Today! Smoking Cessation Classes beginning January 6, 2015! Start your new year off right and keep that new year’s resolution. UNM Truman Health Services is offering Smoking Cessation Classes from 4:00 PM to 5:30 PM starting January 6th. Class schedule is: January 6, 2015
January 13, 2015
January 20, 215
January 29, 2015
February 3, 2015
February 10, 2015
February 17, 2015 For more information on registering for these classes please contact THSInfo@unmmg.org. At UNM Truman Health Services YOUR health comes first! In our ongoing effort to ensure we are meeting your health care needs, we are asking for your assistance in the following: Medications– Please bring your medications when you are scheduled to meet with your provider. Your provider will compare them with the list of medications in your medical record. Other Appointments-If you’ve been seen by a provider outside of the UNM Truman medical system, please let us know so we can request your treatment record.
Hand Hygiene-You may be asked if the clinical staff practiced good hand hygiene during your visit. Clinical staff should clean their hands every time they enter and leave the exam room. Reminder Calls–You will receive a reminder call about your appointment. The caller may also need to share important information during this time to help you prepare for the appointment.
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We know your time is precious and so is ours, if you have more than one appointment scheduled in a day, it is YOUR responsibility to tell your doctor. If your first appointment runs over, you may miss your second appointment and need to reschedule.
Employee Recognition Program
Need Medication Refills? No Refills Left? Call your pharmacy for all refills 14 days in advance
UNM Medical Group, Inc. (UNMMG) is committed to recognizing exceptional employee performance and/or contributions to UNMMG. The Rewards and Recognition Committee developed an Employee Recognition Program named Way2Go. Visit the front desk for forms to nominate a THS employee.
PLEASE DO NOT CALL THE CLINIC MEDICATION REFILL PHONE NUMBERS UH Pharmacy 272-2309
DOH in Santa Fe 1-800-254-4689
Nominees must meet at least one of the following in order Curant Health (HealthStat RX) 1-866-437-8040 ext. 245 or to be eligible: ext. 224
People-Respect, diversity, teamwork, collaboration, reliability
Quality-Continuous improvement, innovation, commitment to exceptional quality work
Service-Excellent customer service, exceptional service to UNMMG and community, dedication and exemplary commitment as a UNMMG employee, environmentally conscientious
We Will Miss You Please let Truman staff know if you are planning to move away from the area. That way we can:
Finance-Initiatives and/or efforts by staff that may impact revenue
Growth-Professional development, self-motivation, initiative
Ensure you have your medications for a couple of months. Supply you with all of your most important records for your new provider. Help you find resources in your new community.
Don’t let your medical care lapse! SAGE (Services & Advocacy for Gay, Lesbian, Bisexual, and Transgender elders) is the country’s largest and oldest organizations dedicated to improving the lives of lesbian, gay, bisexual, and transgender (LGBTQ) older adults. Founded in 1978 and headquartered in New York City, SAGE is a national organization that offers supportive services and consumer resources to LGBTQ older adults and their caregivers, advocates for public policy changes that address the needs of LGBT older people, and provides the training for aging providers and LGBT organizations through its National Resource Center on LGBT Aging. SAGE Albuquerque has become a major program of the Common Bond New Mexico Foundation mission and is directly managed by an Advisory Board comprised of seniors who are key leaders within the LGBTQ community. Monthly support/social meetings, monthly coffee hour for women, coffee hour for men, local senior outings and bereavement support group. To learn more about the Albuquerque Chapter of SAGE, including meeting place and time, please contact Katherine Palmer at Kath_Col@yahool.com or call 505-710-6987.
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Transportation Options for Patients Sometimes getting to your appointment is difficult, we understand. If you are having issues getting to your appointments because of lack of transportation, be sure to speak with one of the UNM Truman Health Services case managers about receiving assistance. Patients with full Medicaid and are enrolled with Blue Cross Blue Shield, Molina, Presbyterian, or United Health Centennial Care, will receive transportation through Medicaid to medical and behavioral health appointments. Please note you have to arrange for transportation services at least three (3) business days in advance. An additional transportation option is Sun Van. Sun Van provides door-to-door rides for patients with disabilities. There is a written application process, a portion of which must be completed by a physician, and an interview. Once approved, there is a $2.00 per ride fee. Albuquerque Rides buses are another possibility, but if you are having a difficult time getting a bus pass, check with your case manager for possible solutions. You may qualify for a free or reduced-priced bus pass through another agency or from UNM Truman Health Services. For more information on transportation services contact your case manager or email us at THSInfo@unmmg.org.
UNM Truman Health Services No Show and Utilization Cancellation We understand that issues may occur, and you may need to cancel an appointment. If this happens, we respectfully ask that you contact our office in advance to reschedule your appointment. Please note for dental and complementary therapies you must be an active UNM THS patient receiving primary medical care at the clinic, and be seen at least once every six months as directed by your provider. Our complementary therapy providers (acupuncture, chiropractic and medical massage therapy) want to be available to meet the needs of all our patients. When a patient does not show up for a scheduled appointment, another patient loses an opportunity to be seen. If patients do not contact our office to cancel or reschedule a complementary service appointment, preferably 24 hours in advance, any future appointments will be canceled. Two (2) consecutive no shows or cancellations will result in future appointments being canceled and you will not be able to reschedule with our complementary providers for six (6) months. This policy will enable us to open otherwise unused appointments to better serve the needs of all patients. Thank you for your understanding and cooperation.
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Have You Heard Tell Us How We are Doing!
We are now on Facebook and Twitter! Looking for the most up-to-date information on
The latest patient survey concerning telephone response is now available at the registration desk. Please be sure to stop by and pick one up. Remember, the only way we can improve is by receiving your feedback. For more information on the patient survey or if you have any questions please contact us at THSInfo@unmmg.org
what is happing at UNM Truman Health Services? Like us on Facebook (UNM Truman Health Services) or follow us on Twitter (UNM Truman). Great tips on staying healthy, UNMTHS activities, clinic closings, outreach activities, and more can be found here. Stay in-touch and stay informed!
“We can’t make thins better if we don’t know what is broken”.
U.S. HIV Rates Down (Originally printed in PA: Positively Aware, September/October 2014) Researchers from the Centers for Disease Control and Prevention (CDC) reported that the annual HIV diagnosis rate in the U.S. has gone down more than 30% in the past decade. However, diagnoses remained stable for men who have sex with men (MSM) and even increased in certain groups; ages 13-24, 45-54, and 55 or older. The CDC research letter published in JAMA July 23-30 noted that, “Although increases in diagnoses were found in young [MSM], reports show that many at high risk do not test annually and the overall percentage of youth who have ever tested for HIV during the period of analysis was low compared with other age groups. Among [MSM], unprotected risk behaviors in the presence of high prevalence and unsuppressed viral load may continue to drive HIV transmission.”
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Notice of Privacy Practices Your providers and staff members at Truman Health Services want you to know your rights, and our responsibilities when it comes to your health information. YOUR Rights include… Copies of your electronic or paper medical record—submit requests to Health Information Management Corrections to your medical records—if you find incorrect information in your record, let us know so we can assist Request confidential communications—you can ask us to contact you in a specific way; for example, home or office phone, or by mail Ask us to limit what we use or share about your health information—there are specific guidelines to this request so please ask for assistance Get a list of those with whom we have shared information—again, there are specific guidelines to this request so please ask for assistance Get a copy of the UNM Health Sciences Privacy Notice—copies of this document are kept at our reception desk, and are available in English, Spanish and Vietnamese File a complaint if you feel your rights have been violated—please ask us for assistance OUR Responsibilities include… We are required by law to maintain the privacy and security of your protected health information We will let you know promptly if a breach occurs that may have compromised the privacy of security of your information We must follow the duties and privacy practices described in the UNM Health Sciences Privacy Notice, and offer you a copy We will not use or disclose your information without your written consent. Please see your case manager for assistance with the, “AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION” form. For more information, or questions regarding this information, please contact: Sonya L. Smith Clinical Compliance Manager UNM Truman Health Services 505.272.1312 Reference Information: UNM Health Sciences Center & UNM Health System, Notice of Privacy Practices, September 23, 2013. Visit: hsc.unm.edu/admin/privacy
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Getting the flu is no fun, but when you are HIV-positive getting the flu can be life-threatening. Flu pandemics occur when a new strain of influenza (the flu) emerges for which people have no immunities, and no vaccine exists. According to the CDC (the Centers for Disease Control and Prevention), “people with HIV are at high risk of serious related flu complications”. Studies have shown people living with HIV have an increased risk for heart-and-lung related hospitalizations during flu season. It has also been determined that flu symptoms might be prolonged in people infected with HIV. Because of the serious complications caused by the flu it is highly recommended HIV-infected persons receive the flu vaccinations. People with advanced HIV disease may have a poor response for the vaccination. In this event, the use of antiviral medications may be used to help prevent the flu infections. There are things you can do to help reduce your risk of catching the flu; *Cover your mouth if you sneeze or cough. One of the best ways to reduce the spread is to cover your mouth when you sneeze or cough (use the crook of your arm instead of your hands) This helps reduce the hand-to-hand spread of germs and droplet sprays from sneezes or coughs. *Wash your hands on a regular basis, especially if you come in contact with someone who is sick. *The best way to wash your hands is with soap and water for 15-20 seconds. *Use alcohol-based hand gels when washing is not possible. *Wear a mask. If someone is coughing or sneezing next to you, wear a mask to help reduce the chances of you inhaling the flu gems. *Do not share items such as drinks or personal items. *Do not bite your nails and keep your hands away from your face. *Try to avoid crowds during flu season. This isn’t always practical, but it will help reduce your risk. *Get a flu vaccine. UNM Truman Health Services is offering free flu vaccines at our shot clinic on Mondays and Thursdays from 1 pm to 4 pm. For more information speak to one of our Patient Services Coordinators or speak to your provider.
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A very special thank you to every one who participated in the 2014 World AIDS Day Events. Our panel speakers included: Martin Walker Also, a big thank you to everyone who helped to make the candlelight vigil a special event. We had over 200 people in attendance at this moving event. Thank you to:
The United Court of the Sandias
The New Mexico Gay Men’s Chorus
Javier Rios
First Nations Community Healthsource
The Albuquerque Chapter of Delta Sigma Theta
AmeriCorps
The Highland High Key Club
AltaMoni
Taralynn and AJ Martinez
Diggs Catering for the Hot chocolate and Coffee
And the staff of UNM THS
World AIDS Day 2014
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National Black HIV/AIDS Awareness Day is February 7th. Conceived by five national organizations; the Concerned Black Men ,Inc. of Philadelphia; Health Watch Information and Promotion Services Inc; Jackson State University-Mississippi Research Center; National Black Alcoholism and Addiction Council; National Black Leadership Commission on AIDS. This group came together to help bring awareness to the Black African American community, has become one of the fastest growing HIV-positive diagnosis. Help UNM Truman Health Services reduce the spread of HIV by getting tested on February 7th. For more information on events and testing hour please contact us at 505-925-7286 or THSOutreach@unmmg.org.
The Real Valentine’s Day There is a lot of folklore surrounding the origins of Valentine’s Day. One of the most common legends is in ancient Rome, Emperor Claudius II decided single men made better soldiers than married men. He declared that single men could no longer get married. Valentine, realizing the injustice of this declaration, continued to marry young couples in secret. When the Emperor discovered Valentine’s actions, he had Valentine put to death. Another story has Valentine falling in love with a young woman, and as a priest he was not allowed to marry. He eventually married her in secret and when found out he was put to death. Prior to his death he wrote a note to his young wife and signed it “from your Valentine”. Valentine greetings have been around as far back as the middle ages, although written valentines did not appear until after 1400. The oldest written valentine still in existence was written in 1415 by Charles, Duke of Orleans to his wife while he was imprisoned in the Tower of London. (The greeting is now part of manuscript collection in the British Museum) Valentine’s Day is celebrated in the U.S., Canada, Mexico, the United Kingdom, France, and Australia. The modern day Valentine’s Day became popular in Great Brittan in the 1700s. By the middle of the Century it was common for friends and lovers of all social classes to exchange small tokens of affection or written notes. American’s most likely began exchanging hand-made valentines around the early 1700s. However, the first mass produced printed valentines began in 1840. According to the Greeting Card Association, an estimated one billion greeting cards are exchanged every year on Valentine’s Day!
With the flu season on us good hand hygiene is important. Remember to wash your hands when you touch your face, sneeze, or cough to help avoid the spread of germs. If you do have a cough please think of you neighbors in the waiting room and put on a mask. Mask are available at the front desk or upon request.
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When at Truman... Please be sure to turn your phone off or to silent when you enter the building. Stay in the lobby once you have checked in. This means you cannot go outside for a cigarette or for any other reason. We are happy to provide you beverages from our beverage cart, but remember, if you provider is ready to see you when you check in, you may have to wait for that tasty treat. If you are not available when we call you, you will have to wait until your doctor has an opening later that day, or you will have to reschedule to a different day altogether.
Dental Care for UNM Truman Health Services Patients UNM Truman Health Services & UNM Dental Services Have Joined Together To Provide Dental
Dental Care is an extremely important part of your continued health and well-being. If you don’t have a dentist you see on a regular basis and are interested in receiving dental care through UNM, you must be under the care of a UNM THS provider. Enrollment forms are also available at the front desk.
DON’T FORGET! UNM Truman Health Services now offers Outpatient Pharmacy Services through Curant Health (formerly HealthStat RX). Personal Care managers, free home delivery, and free bubble packing are currently available. For more information ask your Nursing Team. Remember-Narcotic pain medications cannot be called into your pharmacy by your physician, and therefore cannot be filled at night or on the weekends. Please DO NOT call the after-hours answering service to request pain medication refills. Plan ahead to be sure you renew your prescriptions before your run out. Remember-To update your new phone number and address with the pharmacy too. They may need to contact your about any medication issues or concerns. Remember– UNM Truman Health Services will not accept any medications for disposal. Please stop by the front desk for a list of local disposal sites. Note-only pills will be accepted at the sites listed.
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UNM Truman Health Services Pharmacy Selection
UNM Truman Health Services supports the patient’s right to select a pharmacy that will best suit their needs. Our providers will gladly submit your prescriptions to the pharmacy of your choice. UNM Truman Health Services provides mail order pharmaceutical services to our patients if our patients so chose from Curanthealth. Curanthealth offers specialized pharmacy services designed to improve the therapy results of your specific chronic condition. Their core focus is to provide a more personal approach in patient care, so they can create a customized medication plan to fit your lifestyle. Curanthealth pharmacy services include
Convenient Pharmacy Home Delivery-Medication is delivered directly to your doorstep or to UNM Truman Health Services for you to pick up.
Custom Blister Packaged Medications– Prescriptions can be packaged to fit your own daily routine. No more fumbling over multiple bottles.
Dedicated Personal Care Coordinators-Available to help patients with medication therapy through written education al materials regarding prescriptions, following up on a consistent basis with both patient and physician. This team approach set Curanthealth above other pharmacies.
Specially Trained Pharmacists-Their experienced chronic disease pharmacists offer unsurpassed knowledge with consultation available 24/7.
No co-pays, deductibles, or co-insurance-UNM Truman Health Services understands the importance of the patient adhering to their medication regimen. Financial constrains should not prohibit the patient from taking their medication so UNM Truman Health Services will cover your co-pay, deductible, or co-insurance to ensure that you never have to go without your medications due to the inability to pay.
UNM Truman Health Services works with Curanthealth, Walgreens, Highland Pharmacy, Pharm Blue, CVS, Wal-Mart, and a variety of other pharmacy choices. All proceeds from prescriptions filled at Curant comes back to UNM Truman Health Services to help enhance and expand our patient services for people with HIV living in Albuquerque. *Access to all pharmacies for your prescriptions, including Curanthealth, will depend on your insurance coverage. Tell us what you think of the new Truman Times layout and let us know what you would like to see in this publication. Your feedback is important to us. So come on, Share!
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Classified Looking For More Information? UNM Truman Health Services now has two ways for you to get in touch with us. For general information or questions please contact us at THSinfo@unmmg.org. For information on educational events and HIV rapid testing locations around Albuquerque contact us at THSoutreach@unmmg.org.
Free Lab Draws & Testing For your convenience you can now get your labs drawn at UNM Truman Health Services. Lab draws at UNM Truman Health Services are by APPOINTMENT ONLY during the following days and times:
Tuesday 1pm-4pm
Wednesday
Thursday
8am-11am
1pm-4pm
Friday 8am-11 am
Due to health concerns for patients and staff, UNM Truman Health Services is a fragrance free zone. This includes perfumes and colognes. Please refrain from using these until after your appointment.
Good News! If