5/14/2026, 12:53 PM EDT TO: +16045227206 FROM: 18335201506 OPIFINY PAGE 2/5

canada life opifiny’ REQUEST

Group Disability

Dr. G. Ademiluyi

Mark Holand

Reference ID : 130684485

We are reviewing Mark Holand's claim for disability benefits and require current medical E

‘information for our assessmen formation requested. Please —

Note that a medical appointment may not be req if you have recently assessed your —
ent. The responses can be based off the most recent assessment.

Document Upload

1. Please upload a complete copy of your patient's medical records, including clinical notes,
consultation reports and test results for the period noted below. There are a few ways you
can submit these documents - let us know which way works best for you.

from February 2, 2026 to the present

(1 | will upload all of the requested information along with this online submission.

C1 | will fax all of the requested information to Opifiny at (833) 520-1506.
Please note: For proper transmission, please include all previous Opifiny fax
cover pages sent to you in your fax submission.

C | do not have all of the requested information, | will fax some of them to Opifiny at (833)
520-1506 and the rest at a later date.

Please let us know the date each missing document will be available for
submission.

C2 | will not submit the requested information (please state reasons).

Questions? Please call Opifiny* Customer service: Generated by opifiny | Request # QHBZWWZTH | May 14, 2026
By phone at 1-833-OPIFINY or by email at support@opifiny.com Page 2/5