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Get Members Of The Board. Form 8-k (current Report Filing) Filed 08/03/11 For The Period Ending 08/03/11

Human Resources Division Employee Health Services 333 South Beaudry Avenue, 14th Floor - Los Angeles, CA 90017 Telephone: (213) 241-6326 - Fax: (213) 241-8918 JOHN E. DEASY, Ph.D. SUPERINTENDENT OF SCHOOLS VIVIAN K. EKCHIAN CHIEF HUMAN RESOURCES OFFICER ROSA L. MERCADO, M.D. DIRECTOR, EMPLOYEE HEALTH SERVICES AUTHORIZATION FOR RELEASE AND/OR EXCHANGE OF MEDICAL INFORMATION I, DOB (Employee, hereinafter Patient ) hereby authorize LAUSD Medical Directo.

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