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Shands
at
the University of Florida
P.O. BOX 100345
Gainesville, L 32610
Date: 03/25/08
NEIL GILLESPIE
NEIL GILLESPIE
8092 SW 115TH LOOP
OCALA, FL 34481
RE: GILLESPIE, NEIL
We have received your request for medical information, but are unable to process it for
the following reason(s):
See below
Attached is a complete copy
of
your medical records from the Shands Hospital chart.
The original request and authorization is enclosed. Please resubmit the additional
information along with the original documents.
Ifwe
may be
of
further assistance, please feel free to contact us.
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h a r t ) n c ~ Inc.
TIli\NI(
V()U F()f{ lJSINeJ
)UR
SERVl( ES
I hIS
has referred your request for rcproduct
ion
or nledical records
to
( hart()ne, Inc. for processing.
Please nOll
thIS
Inf()rn1alion rnay have been dIsclosed to you f} on1 records vvhose confidentIality is
by federal la\v Federal
(4-2
C FR, part 2). prohibits you fl onl
J11aking
any further
disclosure of thesc records \vlthout \Vr1ttcn consent of the person to \VhOnl it pertains, or
as
othcnV1se pernl1tted such j authorization for the release of Inedical or other
In
fonnation IS not suffic1ent
for
this purpose.
\Ve realize you have a choice to use the services
of
( han()ne. Inc., to provIde you \vith
the
reproduction of
the records you
requestIng or to nlake other
arrangeillents
\vhich. depending upon 1he facility and
include the lise or a record rcproductlon service or Il1ay include copyIng the
records \Ve appreCIate ha\
Ing
the opportunity to serve you and \vould like
to
continue
processLng your
requests at this l ~ l c i l i l y
Enclosed
is
our HIVOICC for
~ e r v i c e s
rendered
in
providIng the reproduction or the n1edical records you
()ur
feeS
are based upon I nurnber of cnlcna Including state or federal statutes (\vhere
and rnay c o n ~ l S t of a fee, a per page f cc. s a l e ~ ta.\ \vhere applicable. and/or shipping and
that include both and delivery
(Llnlcss
stated
in
your request lhat the records
\\:111
be up
at
the
L1Cility).
()ur ~ e r \ ices arc intended to provide
to yOll
a high quality producl
at
a
r c a ~ o n a b J e pnce,
Should ynu ha\ c
any
q u c ~ u o n s our ~ e r \ 1 C C ~ .
contact our C ustolner Service [)epat1rnent at
:-
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03-07-2003 04:09
NEIL GILLESPIE
PRGE2
O l d f t o 3 ~
FA
~
¥
r;
I P18 0111111111111111
Shand6 at Univoriity of nDttdil PO Rnx 1003"5, Gains& Villo•• L 32610-0.145
3,;
;L ' }.6
;
RlOOO1
~ o n 8 : (352) 265-0131
Fax: (352)
265-1098
o Shands Lake Shore 368 NE Franklin Slreel.
Lake
City, FL 32055
ptwrlc:
(386) 754-6100
Fax: (388) 754-8106
Shands
o
~ n 8 l 1 ( 1 S
I lVe
Oak
1100
SW
11th t;treet,
LivA
Oak. FL 32064
Phone: (386) 362-0800
I (386) 3iji'-oRQ1
X:\
:i,-::d
thi
( , ~ : ...:)
Ct"
o
Shand& Starke
922 t. CeJl Atr..t,
Starke. FL
32091
Phone:
(9 V
,
Tk
.
.Ii Ie.
Name: __
J _ ~ _ I - - I '
' 1 . - - ~ = . ~ , _ I _ J t * _ 5 ~ ~ t 3 - ' : : I ~ C ; _
Attention: ,
Telephone
:
So
9J
$ LV 1/6
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kt.p
&;
ddress:
C9Ct:d?
, _
ity:
State:
8
~ , - \ ~ J ~ l l - ~ r t
Purpose
of release For
flxcUllplfJ: contillued
c..1fP.,
per.qonsl.
etc.): . . ~ . . . . ; : f t : . ; ; ; - . 2 - ~ . c ; : : a · .
u ; ; . . ; ; ~ . . . . . ; . . . . ; ; L = : . . . .
_
.,/ r .
Specific items or
dates needed: --' f...JJJ.:".(Y 1 '11(1
'Ill;,,'
6 ~ ~
t 9 ) r / _ L - N t - = - ~ = - - _
I I
Cardiovascular Reports
n EKG Report 0 Laboratory Results
I I Pathology
Report. '
n Radiology (X
ray) Reports 0 History &
Physical U
Operative Report
n Discharge
SuinmkY.
L.'J
Emergency Room I I Other _
Needed
for doctor's appointment
on: .
,.
.
'
-t
(Date) (Time)
':
.."
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This authorization is
release
of medical records
and
information inclUding ~ i a g n o s i 6 . treatment. and/or X ~ i n a t i ~ n r e l a , . l , ~ d ~ , . ~ , ~ ; : : : : r - , -,-, ' ~ \ f -
mental health (psych.atry or psychology). drug and/or alcohol abuse. HIV testing/AIDS. and sexually transmiSSIble d l s e a s ~ i ~ : · . ,. ···· ~ ~ ; ; · ~ ~ ~ i ~ ~
•• i _ _ ~ ~ . . . ' ' I I t•.) -
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03-07-2003
04:08 NEIL
GILLESPIE
PAGE1
Fax
From:
Neil J. Gillespie
8092 SW 115
th
Loop
Ocala, FL 34481
Telephone: (352) 854-7807
To: Patty
Cuello
Health Information & Record Management
Fax:
(352) 265-1098
Date: March 3 2008
Pages:
two
(2)
including
this
page
Re: Wa,nt to
schedule appointment to view
my
medical records
Sllands IIealth Infonnat1 )n cmd Records Management Department
[0:
Patty
u e l l o ~
Accompanying this fax is a signed authorization for Usc
or
Disclosure
of
Protected I lealth
Infonnation.
I
want to schedule an appointment to view my medical
and
any (lther i l e s ~
such as tinancial records. Please contaL1 me to schedule an appoin1mcnt.
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j
.
SHANDS HOSPITAL
at the University
of Florida
Gainesville, Florida
32610
THIS
MEDICAL RECORD
IS THE PROPERTY OF
SHANDS
HOSPITAL AT
THE
UNIVERSITY OF FLORIDA MEDICAL CENTER AND CANNOT
BE
REMOVED FROM
THE
MEDICAL CENTER WITHOUT A COURT
ORDER,
SUBPOENA OR STATUTE.
PLEASE NOTIFY THE
RECEPTIONIST,
SECRETARY AND/OR HEALTH INFORMATION
AND RECORD MANAGEMENT PRIOR TO REMOVING THE MEDICAL RECORD FROM
A DESIGNATED AREA WITHIN
THE
MEDICAL CENTER.
PATIENT ALLERGIC/ADVERSE REACTION: (To
Be Completed by
Physician
DATE
DRUG
SIGNATURE
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Plastic
and
Reconstructive Surgery
SHANDS CLINIC
at ark
venue
1015
NW
6th Terrace
Gainesvill e, FL 32605
352/395-6810
352/395-6811 Fax
February 4, 1997
CLINIC NOTE
RE: GILLESPIE, Neil Jose
:MR 01
04 40 32
This
is
40-year-old gentleman who has velopharyngeal insufficiency after unilateral cleft
lip palate treatment. He had an attempted pharyngeal flap done by Dr. Mallard in about
1990. The flap dehisced and therefore was a failure. He has been managed with an
obturator and he
is
doing moderately well. He
is
still interested in the surgical solution
if
that
is
possible.
He is
in good general health otherwise. His physical examination today
indicates a relatively unremarkable situation except that there is no uvula and when the
palate is lifted with an "Ah" kind
of
sound, it is clear that this elevation is more of the
shape and it isn't very much the prominence in the midline, otherwise unremarkable. I
have a report from the videofluoroscopy indicating a 11-12 mm gap. Apparently he had
nasal pharyngoscopy today.
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·
.
Craniofacial Center PO Box 100424
Health Science Center
Gainesville, FL 32610-0424
Telephone:
352)
846-0801
Fax
352) 846-1539
e-mail: [email protected]
Clinic Report: Videofluoroscopic assessment
o
the velopharyngeal
port
during
function for speech
Re:
Neil Gillespie
Dental No.:
~ B g 41
Medical No.:
10-44-032
This forty year old white male was seen on November 25, 1996
for
a videofluoroscopic
assessment
o
his velopharyngeal port during function for speech.
Mr
Gillespie is currently
wearing a speech bulb obturator, and his speech resonance frequently alternates between
hyponasality and hypemasality. The purpose o today' s filming was to determine the size,
configuration and placement of the bulb in the nasal pharynx to determine i alteration o
these factors can improve his overall resonance quality. The nasal pharyngeal structures
were coated with a thin barium sulfate solution to aid in defining soft tissue contrast.
Records were obtained in the lateral and frontal (A-P) planes with and without the speech
bulb obturator.
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Neil Gillespie
Fluoroscopic assessme..
f
VP Function for
Speech
November 25
1996
In summary,
Mr.
Gillespie presents with a speech pattern characterized by near normal
resonance but which frequently alternates between byponasality and hypernasality.
He
is
currently wearing a speech bulb obturator and
today s
assessment revealed p lacement
and
configuration to
be
near optimal. Without the obturator,
Mr.
Gillespie s speech is
significantly hypemasal and although the velum elevates appropriately there remains a
consistent gap
of
10 - 12 mm during speech.
In
order to further define whether
any
improvement can be made to the speech bulb obturator
or
if a secondary surgical technique
might be a viable consideration, a nasendoscopic assessment should be conducted.
IT I can be
of
any further assistance in the interpretation of this fIlm please call me at (352)
846-0801
j ~ ~ t ~ ~
W. N. Williams, Ph.D.
Speech-language Pathologist
cc:
Mr.
Neil Gillespie
1121 Beach Drive, N.E.
Apt. C-2
5t. Petersburg, FL 33701-1434
Mr. Glenn Turner
P.O. Box 100435 JHMHC
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..
• SHANDS
HOSPITAL
. . at the niversity of Florida
F CE SHEET
COUNlY
SPEC.
HANDUNG
FL 33701
5497Zi
WORK
01044032
MEDICAl.. RECORD
NUMBER
i 605Z5 i7A
WA
PHONE
WORK
STATE
ZIP
150-52
36 0) 785-
53··: It9
DISABLED
DISCHARGE DATE
HOME
HOME
EMPlOYER
NAME
31
01Y STATE
ZIP
Na
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.
"
SHANDSTEACHINGHOSPITALANDCLINICS, INC. (SHANDS HOSPITAL)CERTIFICATION
AND
AUTHORIZATION
Patient Name ~ \ O J >
Q.
~ q { u Admission Date \ \ -
C>l :=S -
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·
.
_
fG3'l.1 'I ,,,,,
fG 03 1._ 1._
J 00
1.1 01. 04 01001861
AMES COLOR-FILE
12 PARI(
STREET
SOMERVILLE, MA 02143
_ _
0
~ ~ r : 9 1 \ 3 \ 6KP:355816516 00002
1-800·343·2040
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