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® 09/21/2012 08:45 12092242 DELTA REHAB AND CARE PAGE 01/02 <br /> FAX COVER SHEEN' <br /> Delta Rehabilitation and Care Center <br /> 1334 South.Ham Lane <br /> Lodi, CA, 95242 <br /> (209) 334-3525 <br /> Fax(209) 224-5262 <br /> Send to: From: � <br /> Attention: Date: <br /> LrC©x S O • �� zoo <br /> Office Location: Office Location: <br /> Fax Number:, Oar' Phone Numr: <br /> .> <br /> E'Urgent [:]Reply ASAP =Please Comment ❑Please Review ❑For Your Information <br /> Total Pages Including Cover: <br /> If any pages are not received,please contact Delta Rehab immediately. <br /> Comments: <br /> C"0/5/ of <br /> Confidentiality Statement <br /> This FAX is intended for the use of those to whom it is addressed and may contain information that is privileged,confidential,and exempt from <br /> disclosure under applicable law(s). If the person receiving this is not the intended recipient,employee or agent responsible for delivering this <br /> message to the intended recipient,you are hereby notified that any dissemination,distribution or copying of this communication is strictly <br /> prohibited. If you have reecivcd this FAX in error.please call(209)334-3825 immediately and return the original to us.Thank,you. <br /> Received Time Sep. 21, 2012 8: 45AM No. 0264 <br />