Mar 12, 2026 11:58 To: +16042339777 Page: 44/46 From: Foremed Medical Clinic Fax: 16043985614 FRASER HEALTH AUTHORITY Emerg Note Royal Coitumbian Hospital HOLAND,MARK THOMAS RC0473383/25 | Temperature 36.7 C | 05/03/2026 11:46 | | Temperature Source __ oral | 05/03/2026 11:46 | Pulse Rate | 417 | 05/03/2026 11:46 | | Respiratory Rate 1 16 | 05/03/2026 11:46 | : Blood Pressure | 153/103 H | 05/03/2026 11:46 _ Pulse Oximetry _ 98 | 05/03/2026 11:46 | Documentation Presentation: This patient has had multiple presentations to the emergency department for somewhat bizarre complaints. I have also reviewed the available history as well as a psychiatric consultation. His primary complaints seem to be related around ear pain. He tells me that he believes that a specific frequency of sound is causing him to lose his hearing and that this “impacts his vagal nerve and causes him to have seizures”. I have revicwed the footage of him sleeping that he has shown me and I do not see any evidence of tonic-clonic movements. In his previous visits he has demanded to see an otolaryngologist and these referrals have already been completed. He has already had audiology testing completed. He does seem quite fixated on his health and says that his general health is declining. Relevant Medical History: Migraines Medications: Per med rec Social History: Denies recreational drugs or intoxicants today Exam: He appears well, nondistressed, This record contains confidential information which must be protected. Any unauthorized use or disclosure Is strictly prohibited. Meditech Report !D: 0503-00199 2o0r4 PAGE 44/46 * RCVD AT 3/12/2026 11:59:36 AM [Pacific Daylight Time] * SVR:FAXP21/12 * DNIS:9777 * CSID:16043985614 * ANI:6043985614 * DURATION (m