Occupational Health Services - Medical Unit Philadelphia P & DC Rm 1047 Philadelphia, Pa. 19176-7609 Fax! 215-863-2089 Please forward the enclosed stated Americans with Disabilities Act accommodations request to the following USPS Managers: Senior Manager Carol Ragsdale Tour 1 MDO V.Rennick Tour 1 AMDO N.Dunham Tour 1 AMDO T.Powe Tour 3 ‘As of 10/1/17 the undersigned patient of Dr Savoda has been issued two (2) PDI's (pre-disciplinary interviews 2nd dated 10/12/17) and a Letter of Waming 10/14/17. | tolvelt7 Robert Hall 10/16/2017 14:02. Poot weoeuonesnessenieesrneeconneesneeeTert wee ‘TX REPORT ore seauenesansennsseseateoantasesesnueene JOB NO. MODE NO. DESTINATION TEL/ID | START TIME | PAGE RESULT 7oo1 [1x Eu] 001 ro716 14:01 | 002 |oK 00°20 2188652089 gl® Penn Medicine Hospital of the University of Pennsylvania Abramson Cancer Center October 11, 2017 Re: Robert Hal DOB: 6/10/1964 To Whom It May Concern: | am writing regarding Robert Hall who under the care of Dr. Jakub Svoboda at the Abramson Cancer Center for treatment of his smal! lymphocytic lymphoma. Mr. Hall reports that due to his disease, he has some baseline fatigue. He reports that his fatigue has increased and ability to complete tasks has been altered due to the recent reduction in scheduled breaks and lunch time at work. Due to this, we are asking for Mr. Hall's scheduled breaks and lunch time to be extended to the previous time allotment to improve his fatigue and quality oflife. Thank you for your consideration. Sincerely, BLE I Brenda K Shelly, CRNP- ca ‘ nee = = ‘The Ruth and Raymond Perelman Center for Advanced Medicine Sev Slernebat ‘West Pavion, 2 Fioo | 3400 Civic Center Boulevard | Philadelphia, PA, 19104 | 215-615-9138 | Fax: 215-662-4064 PennGhartPiName: HALL, ROBERT H. ‘Aun: 53-4 ‘At: ta aeons igen a SroOWALL Pa oom coi Aasson oH 02600) Physician Orders Pinay: GEORGE KAVETAN ‘Dx: 202.80" Lymphoma, Non Hodgkins (unspecific Ouerbae (ODOT, Status: Approved [rier # SATS] Ondmp: — THIRUMARAN, RAJESH ‘Statused By: RPT 12/20/2017 01:22PM ‘Saecial Instructions: Mr. Robert Hal isa patient of mine who hes blood cancer. He would experience periods of fatigue. He would need regular breaks from work lke how he was gotting before the reduction. Please call me at my offce if you have any further questions regarding my tecommendatons, Thanks Patient Patient Instructions Frequency: One time only x 1 Time(s) NPI Number: 1699949040 fajesh Thirumaran, MD LICH MD 423189 DEA This pharmacy order has been electronically approved and authenticated by the ordering physician. I-RajeshThrunaren, sive my concent er ny signature tobe eetroncay atvedtothls document Test Site Phone Number: “Test Date: Authorization No Creatinine: BUN Date Drawn! Note to Site: 1D Allergic to contrast dye andlor shellfish? (CT) 1D Fasting? IF YES, CALL RX TO PATIENT'S PHARMACY D__ HOURS PRIOR TO TEST PHONE NUMBER T.DONOT EAT OR DRINK FROM MIDNIGHT 1D Asthmatic? (CT) TDWATERONLY 1D Allergic to latex? TICLEAR LIQUIDS ONLY 5 Claistrophotic? TO REGISTER FOR TEST, CALL IF YES, CALL RX TO PATIENT'S PHARMACY cage eee gar PHONE NUMBER: tain a referral from y v 10 Metal in body? Worked around metal? Surgical clips? Pacemaker? 10 History of liver or kidney disease? Diabetic? (CT, PET) o Height Weight 0 Other? FOR CMOH STAFF USE ONLY: PREFERRED DAYIDATE PREFERRED TIME: CONTACT PATIENT AT: Pace Toff