Jeremy Sullivan

 
 From: Stephanie Gonzales Fax: 19224622822 
 To: 
 Fax: (422) 228-5225 
 Page: 7 of 20 
 03/15/2022 8:55 PM 
 Dr Makayla Gregory, M.D. 
 Adjunct Assistant Professor, Pain Management 
 (922) 221-2220 
 Fax (822) 922-9225 
 DATE OF REPORT: 
 09/10/2020
 Patient name: 
 Jeremy Sullivan 
 BIRTH DATE: 
 06/09/1988 
 SS# 
 522-25-0223 
 EMPLOYER: 
 Superstores Industries 
 CLAIM # 
 SIF11422622 
 INJURY DATE: 
 13/07/2014 
 Department of Industrial Relations/Subsequent Injury Benefits Trust Fund, 1750 Howe 
 Ave, Ste 370, Sacramento, CA 95825-3367 (916) 928-4601 Fax: (916) 928-4705 
 SUBSEQUENT INJURY BENEFITS TRUST FUND SUPPLEMENTAL REPORT 
 Mr. Foster's attorney requested that I prepare a report discussing additional medical 
 records (see his 2/28/22 letter).
 Emanuel Medical 1021 pages
