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Ut <br /> San <br /> • e f • { <br /> .. <br /> ty <br /> • nmental Health',DepArtmient <br /> 304 E Weber Avenue FAX #: O (209) 464-0138 <br /> 3rd Floor, Stockton, CA 95202 <br /> Phone: (209) 468-3420 0 (209) 468-8392 <br /> (209) 468-3433 <br /> Date: Time: <br /> FA)C <br /> # of Pages (including this sheet): <br /> To: bAt. av>, FAX: L51o� F ! 7- ` g S� h <br /> Of: <br /> From: _ Voice Phone #CgJ d' <br /> O Urgent For Review o Please Reply . CD Please Recycle <br /> Comments: <br /> . � 6" <br /> f <br /> I <br /> STATEMENT OF CONFIDENTIALITY: The information in this facsimile is legally privileged and confidential information intended only for the use of the addressee <br /> listed on this cover sheet. If the reader of this message is not the intended recipient,or the employee or agent responsible to deliver it to the intended recipient, I <br /> you are hereby notified that any dissemination,distribution or copying of this telecopy is strictly prohibited. If you have received this facsimile in error,please <br /> immediately notify us by telephone at the number listed on this cover sheet and return the original message to us at the above address via United States Postal <br /> Service. We will reimburse your costs in notifying us and returning the message to us. Thank You. <br /> EHD 48-01-012 FAX COVER SHEET <br /> REVISED 6-14-02 <br /> f <br />