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10/14/2013 18:13 209239,193q MANTECARM PAGE 01 <br /> ............... ........ ..... --,.................... <br /> MANTECA CARE AND REHA51LIT .IATION <br /> CARE WITHOUT COMPROMISE <br /> 410 Eastwood Avenue <br /> Manteca,CA 95336 <br /> 209.239.1222 <br /> 209.239,4919 Fax <br /> ............. ............. .................................... <br /> V <br /> 20"i <br /> .......... ......kr <br /> FAX <br /> ..... <br /> F. .. <br /> ........................................... <br /> ro.mWW. b- <br /> To; <br /> 1111. ..:';.:.. hCy.moU <br /> .................. <br /> ........................ <br /> 11 FaxPages: <br /> ................................. ................. .................................................. <br /> ................... .......................... <br /> fPhone: <br /> Date: <br /> ..................11-11'.......... .....................*................................ <br /> -e//�-3............................................................... <br /> Re: fZ cc: <br /> .............I........... ..................................................... ........................................................................................... <br /> .J ...1-111,...I.................... <br /> Comments: I <br /> Disclaimer: <br /> The HIPPAA Final Privacy Rule requires Covered entitles to safeguard certain Protected H&allh Informatlon <br /> (PHI)related to a person's healthcare.Information being taxed to you may Include PHI offer appropriate <br /> authorization from the patient or under circumstances that do not require patient authorization,You,the <br /> recipient,are obligated to maintain PI-11 in a safe and secure manner,You MOY not re-disclose without <br /> additional patient comqenf or as required by low.Unauthorized re-disclosure or failure to safeguard PHI could <br /> subject you to Penalties described in federal (HIPAA)and state law,If you the reader of this message are not <br /> the intended recipient,or the employee or agent responsible to deliver It to the intended recipient,please <br /> notify usimmediatelyand destroy the related message, <br /> .......... ............................................................ .................................... ................... ...................................................................................... <br /> Received Time Oct- 14. 2013 6: 14PM No, 0850 <br />