Deborah Terry

  
 2275 Post St., Suite 275 
 Integrated Pain Care 
 3175 Garrity Way 
 San Francisco, CA 94115 
 
 Tel (510) 68881
 A Pain Management Clinic of Excellence 
 Tel (510) 68881
 Fax (800) 68881
 15-12-2015
 
 Paulette Cass, D.C. 
 88 Belvedere Street, Suite 206 
 San Rafael, California 94901 
 Re: 
 Mr. Floretino Mejia 
 Date of Birth: 
 13-12-1992 
 Date of Injury: 
 12-12-2021
 Employer: 
 Chevy's 
 Occupation: 
 Cook 
 Insurance Carrier: 
 Gallagher Bassett 
 Claim Number: 
 002406-001366-WC-75 
 EAMS #: 
 ADJ8510075 
 Date of Examination: 14-06-2021 
 Interpreter: 
 Spanish 
 INITIAL EVALUATION REPORT 
 Dear Dr. Cass, Attorneys and Claims Professional, 
 Please be advised that the aforementioned injured worker presented to our medical clinic today 
 for evaluation regarding a work place injury per Dr. Cass request for pain management 
 consultation. 
 Please be informed per AMA Code of Medical Ethics Opinion 10.01(5) directs the physician has 
 an obligation to cooperate in the coordination of medically indicated care, the physician may 
 not discontinue treatment of a patient as long as further treatment is medically indicated without 
 giving the patient reasonable assistance and sufficient opportunity to make alternative 
 595
