an equal opportunity/affirmative action university

June 11, 2014

RE: Chase Johnson (DOB 10/05/2005)


To Whom It May Concern:

The above mentioned patient has Type 1 Diabetes, Celiac Disease,
Dysautonomia, Diurnal Enuresis, Ehlers-Danlos Syndrome, and
suspected Mitochondrial Disorder. He requires insulin shots daily or may
be on insulin pump therapy.

When traveling he will be carrying:

Syringes and/or pen needles
Insulin pump
Insulin pump supplies
Insulin vials and/or Insulin pens
Blood glucose testing equipment
Additional supplies as required
Water/Juice and Gluten Free Snacks
Glucagon Emergency Kit

Please do not hesitate to contact us if there are questions in this regard at
(804) 628-7337.

Thank you,

Dr. Gary Francis
Dr. Anshu Gupta
Dr. Melinda Penn
Dr. Dr. Roopa Shankar
Dr. Edmond Wickham
Dr. Mamatha Kambalapalli
Dr. Sara Prupas
Dr. Emily Miller
NP Rebecca Laudenberger-Thalhimer
D Ellen Dionne, RD, CDE
Suzanne Bona, BSN, RN, CPN, CDE

Department of Pediatrics
Division of Endocrinology
Center for Endocrinology,
Diabetes and Metabolism
2305 N. Parham Rd. Ste 1
Henrico, VA 23229

Phone: 804-628-7337
Fax: 804-527-4728

www.chrichmond.org
Dr. Gary L. Francis, MD, PhD, CDE
Chair, Division of Endocrinology &
Metabolism
Dr. Anshu Gupta, MD
Assistant Professor

Dr. Melinda Penn, MD
Assistant Professor

Dr. Roopa Kanakatti Shankar
Assistant Professor

Dr. Edmond P Wickham MD, Assistant
Professor, Director TEENS Healthy
Weight Management Program

Dr. Mamatha Kambalapalli
Pediatric Endocrinology Fellow

Dr. Sara Prupas
Pediatric Endocrinology Fellow

Dr. Emily Miller
Pediatric Endocrinology Fellow

NP Rebecca Laudenberger-Thalhimer

Ellen Dionne, RD, CDE

Suzanne Bona, BSN, RN, CDE, CPN