LSJE, LLC [EFTA00003069]

LSJE, LLC \n6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel: 340-775-8100 Fax: 340-775-8108 \nEmergency Contact Form \nDate: \n09/10/18 \nStart Date: \n08/26/2018 \nEmployee Name: Stephanie Remington \nAddress: \nPhone: \nTitle / Position: Asst to Manager \nSlergency Information: \nAllergies or Health Concerns: \nBlood Type: \nCurrent Medication: \n18-1-3 Estate Smith Bey 00002 \nCell: \nE-Mail: \nMarital Statu,, single \nLicense: \n \nDoctor's Name: \nIsland Health 8, Wellness Center \nPhone \nDoctor's Name: \nIn case of an Emergency, Please contact: \nRelationship \nRelationship \nPhone: \nEnema \n''hone \nl'none \nThis Information is for your safety and the safety of others \nEFTA00003069\n\n--- Page Break ---\n\nLSJE, LLC \n6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel: 340-775-8100 Fax: 340-775-8108 \nEmergency Contact Form \nDate: \n09/10/18 \nStart Date: \n08/26/2018 \nEmployee Name: Stephanie Remington \nAddress: \nPhone: \nTitle / Position: Asst to Manager \nSlergency Information: \nAllergies or Health Concerns: \nBlood Type: \nCurrent Medication: \n18-1-3 Estate Smith Bey 00002 \nCell: \nE-Mail: \nMarital Statu,, single \nLicense: \n \nDoctor's Name: \nIsland Health 8, Wellness Center \nPhone \nDoctor's Name: \nIn case of an Emergency, Please contact: \nRelationship \nRelationship \nPhone: \nEnema \n''hone \nl'none \nThis Information is for your safety and the safety of others \nEFTA00003069