Request No e. Does the request include an equipment purchase (prior approval would have been granted from VIHFA)? ☐Yes ☐No If yes, a copy of the asset purchase form should be included. Note: For subrecipients for which VIHFA is paying all vendors directly, please include a vendor set up form for any new vendor included in this payment request and proof that the vendor has been checked through Xxxx.xxx. Failure to do as such will delay processing.
Request No. 2: Produce all medical records and/or documents relating to the use of the Respironics Device(s) from any Health Care Provider who treated you in the past ten (10) years and who treated you for any disease, condition, or symptom referred to in any of your responses to the questions above and concerning any condition you claim is related to the use of the Respironics Device(s), including, but not limited to, all imaging studies of any part of your body, and laboratory, pathology, and biopsy reports, that relate in any manner to the diagnosis, treatment, care, or management of your condition and the injuries alleged in your Complaint.
Request No. 3: Produce all documents you reviewed, utilized or relied on in responding to the PFS.
Request No. 4: Produce all documents and communications regarding your Respironics Device(s) and/or your Other Device(s), including but not limited to documents regarding any modifications or changes made to your Respironics Device(s).
Request No. 5: Produce all documents and communications regarding your insurance coverage from the date you acquired your Respironics Device(s) to the present.
Request No. 6: Produce all documents and communications regarding any application for life insurance you submitted from January 1, 2010 to the present, including but not limited to any reports of physical examinations conducted therewith and any approval or denial notification from the insurance company.
Request No. 7: Produce all documents and communications for any claim (including a claim for worker’s compensation or social security disability) or legal proceeding for any personal injury you filed from January 1, 2010 to the present.
Request No. 8: Produce all documents regarding the cleaning (if any) of your Respironics Device(s), including but not limited to all documents reflecting any products used to clean your Respironics Device, the frequency of the cleaning of your Respironics Device(s), and any communication with any person regarding the cleaning of a Respironics Device.
Request No. 9: Produce all documents regarding any particulate or dark matter in your Respironics Device(s), including but not limited to any photos or videos of your Respironics Device(s) and any other evidence that you believe shows that the foam in your Respironics Device(s) actually degraded.
Request No. 10: Produce all documents regarding any diagnosed medical conditions or injuries you suffered within the last 20 years, and any medications or treatments that you have been prescribed within the last 20 years, involving the lungs, throat, nose, mouth, respiratory tract, or any other part of the body that you claim was injured from use of a Respironics Device.
