06/22/2015

Dr. Alan W. Burgess 4900 S Monaco St Ste 210 Denver, CO 80237 (303) 584-8165

TO:
	CORPORATE MANAGEMENT GROUP 12000 N WASHINGTON ST # 290 THORNTON, CO 80241

Medical Review Officer Report
-Confidential-

This is a notification of a controlled substance test result on:

Individual Tested: MANUEL PASILLAS Donor ID: 730507380 Collection Site: HealthONE Occ @ North Suburban 9195 Grant St #100 Thornton, CO 80229 (303) 292 - 0034 Laboratory: Quest Diagnostics/ West Hills

Reason for Test: Post Accident Specimen ID#: 6130973 Date of Collection: 06/11/2015 Time: 1144 Lab Accession#: 546271C Lab Reported Date: 06/12/2015 Time: 1124 MRO: Dr. Alan Burgess MD MRO Received Date: MRO Report Date: 06/12/2015 Time: 1715 MRO Date CCF2: Specimen Type: Urine Drug Panel: SAP 5-50+MDMA/6AM/T

Substances included in test profile:

	Drug	Screen	Confirm			Drug	Screen	Confirm
	6-monoacetylmorphine	10	10			Amphetamines	500	250
	Cocaine	150	100			MDA-Analogues	500	250
	Opiates	2000	2000			Phencyclidine	25	25
	Marijuana	50	15

The verified result is:   *** Negative ***

Comments:

Dr. Alan Burgess MD