May 8, 2011
3801 Connecticut Avenue, NW
Washington, DC 20008
Tel. 202 362 7064
The George Washington University
Medical Faculty Associates
2150 Pennsylvania Avenue, NW
ATTN: Medical Records
Washington, DC 20037
I was in out-patient psychotherapy at the George Washington University Medical Center Department of Psychiatry from September 1, 1992 until the end of June 1996. I underwent an initial assessment on September 1 and September 8, 1992 by Napoleon Cuenco, M.D. I entered psychotherapy with Suzanne M. Pitts, M.D. (now deceased) in the end of October 1992 and remained in therapy with Dr. Pitts until the end of June 1994. I entered psychotherapy with Dimitrios Georgopoulos, M.D. in July 1994 and continued in therapy with Dr. Georgopoulos, M.D. until the end of June 1996.
My patient number was 1287229.
1. I would like to obtain a copy of all charts prepared by my treating psychiatrists as well as any other notes or documents relating to my psychiatric treatment from September 1992 till June 1996 prepared by any individuals employed by GW.
2. I would like to obtain a copy of all documents I prepared and submitted to my treating psychiatrists. During my treatment I submitted numerous letters to my treating psychiatrists.
I enclose a completed record request form as well as a money order in the amount of $25.00.
Thank you for your assistance.