Law Offices of RICHARD D, HOFFMAN ‘8383 Wilshire Boulevard, Suite 830 Beverly Hills, California 90211-2445 Tel: (323)782-8600 Fax (323)488-9737 July 8, 2015 Attn: Billing Statement EMERG. DEPT. PHYS. MED. GRP. Good Samaritan Hospital 1225 Wilshire Blvd Los Angeles, CA 90017 RE: Our Client/Your Patient = Nichol Marie Howitt Date of Birth 7 9-23-1975 Dates of Service 7 10/13/2014 Service Location : GOOD SAMARITAN HOSPITAL Date of Accident 10-13-2014 Dear Sir/Madam: This office represents your above-named patient who was treated by you for injuries sustained in an incident whieh occurred on the date set forth above. Enclosed is an Authorization to release confidential information signed by our client Please forward to this office your medical bills for your services rendered to date. We would appreciate it if you would send these documents to us as soon as possible to proceed with the claim of Nichol Marie Howitt ‘Thank you for your courtesy and cooperation in this matter Very truly yours, LAW OFFICES OF RICHARD D. HOFFMAN SARAH SE Legal Assistant (323) 370-6138 iss Enclosure: As indicated