Kathleen Cox

00130 
 Dr Christopher Robinson, M.D. 
 Board Certified Orthopaedic Surgeon 
 Qualified Medical Evaluator 
 MAILING ADDRESS 
 39861 Roberts Gardens
Lake Karen, CO 80397
 PANEL QUALIFIED MEDICAL EVALUATION 
 681 Monroe Extension Apt. 184
Richardstown, TN 57356
 RE: 
 Kathleen Meyer 
 Date of Evaluation: 
 2020 September 12 
 EMPLOYER: 
 Personnel Staffing Group 
 INJURY DATE: 
 2015 August 25 
 CLAIM NO: 
 009193-039254-WC-01 
 FILE NO: 
 239254-0 
 60 minutes were spent in a face to face evaluation with the examinee. 
 FEE DISCLOSURE 
 ML 102-93-95: This is a Basic Qualified Medical Evaluation. 
