Mar 12, 2026 11:58 To: +16042339777 Page: 04/46 From: Foremed Medical Clinic Fax: 16043985614
Fax Server 2/23/2026 9:58:11 AM PST PAGE 3/005 Fax Server

TO:Dr. Ademiluyi COMPANY:

Regarding: 42647481 MARK HOLAND Page 2

Thank you for your earliest attention to this matter. If you have questions, you may call
my direct line, 250.354.5765, or ihe loll free line 1.888.967.5377, local 5765.

Sincerely,
Ms Madison Davidson

Office Assistant Hl] AO
Case Management Services

Enclosure(s}: 10017 Request! for Severed Physician/Psychiatrist Records
Warker’s Signed Release Form 69W1 Worker Auth Release Persona!
Info

PLEASE INCLUDE CLAIM OR ACCOUNT NUMBER IN ALL CORRESPONDENCE

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