EFTA00003069.pdf

VOL00001 1 pages 15 redactions 7.8% redacted

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LSJE, LLC 
6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel: 340-775-8100 Fax: 340-775-8108 
Emergency Contact Form 
Date: 
09/10/18 
Start Date: 
08/26/2018 
Employee Name: Stephanie Remington 
Address: 
Phone: 
Title / Position: Asst to Manager 
Slergency Information: 
Allergies or Health Concerns: 
Blood Type: 
Current Medication: 
18-1-3 Estate Smith Bey 00002 
Cell: 
E-Mail: 
Marital Statu,, single 
License: 
 
Doctor's Name: 
Island Health 8, Wellness Center 
Phone 
Doctor's Name: 
In case of an Emergency, Please contact: 
Relationship 
Relationship 
Phone: 
Enema 
''hone 
l'none 
This Information is for your safety and the safety of others 
EFTA00003069
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Surrounding text: Name: Stephanie Remington 18-1-3 E

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Surrounding text: or Health Concerns ype: Medication:

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Size: 386 x 30 pixels

Surrounding text: Island Health & Wellness Center Phone

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Context contains 'phone' suggesting Phone number
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Surrounding text: hone

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Context contains 'phone' suggesting Phone number
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Surrounding text: others

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Surrounding text: In case of an Emergency, Name ame

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Surrounding text: lame ame Thi

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Extracted image

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People Mentioned
Places Mentioned
Document Info
File Path
VOL00001/IMAGES/0004/EFTA00003069.pdf
File Size
509 KB
Processed
2025-12-21 04:54
Status
completed