Kimberly Baker

 
 Discharge Information 
 Attestation 
 Attestation to: I personally interviewed the patient, I personally examined the patient, I certify that the services 
 provided were clinically indicated and medically necessary for the care of this patient. 
 SIGNATURE: GO MD, JENSEN L 
 On 01 January 2020 20-04 
 Electronically Co-Signed By:GO MD, JENSEN L 
 On: 01 December 2016 08:10 
 patient: 
 Kimberly Baker 
 MRN: 71026105 
 FIN#: 91010105 
 Printed On: 
 10/30/2023 05:11 EDT 
 Page 37 of 516 
 Report Request ID#: 321034108
