NOTE: The information contained on this web page contains privileged and confidential information, including patient information protected by federal and state privacy laws. It is intended only to assist emergency personnel or attending physicians in the event of an emergency where the above patient is unresponsive.

If you are not actively involved in the medical treatment of the above patient, you are hereby notified that any review, dissemination, distribution, or duplication of this communication is strictly prohibited by law.

ABOUT BRENDON: Brendon is the second born of two siblings. Mother is deceased (Mar. 2012). He is an avid sportbike (motorcycle) rider. He has a strong spiritual faith. Brendon enjoys good conversations with friends and listing to legal and thriller audio books.

General Information

Name: Brendon Michael Hall
DOB: Oct. 12, 1972
Brendon's Phone #: Cell: 619-846-3916
(Emergency Contacts are listed below)
Languages: English (Fluent)
Religion: Christian (Protestant - Non-Denominational)
Primary Address: 4136 Georgia St. Apt. 3
San Diego, CA 92103

Government ID

Drivers License #: D0248173 Arizona, United States
SSN: XXX-XX-0605

Primary Contacts

Name: Nina Grobben
Relationship: Aunt
Cell Phone #: 509-675-5073 United States
Home Phone #:: 509-732-6686 United States
Notes: Primary Medical and General Power of Attorney.
DO NOT DISCLOSE HIV STATUS!!!

Name: David Hall
Relationship: Brother
Cell Phone #: 509-675-1154 United States
Notes: Secondary Medical and General Power of Attorney.
DO NOT DISCLOSE HIV STATUS!!!

Name: Dion Doran
Relationship: Partner
Cell Phone #: 619-410-2862 United States
Notes: San Diego contact. Has ACCESS to Brendon's home. Will be able to care for PETS.

Medications & Allergies

Allergies: None

Medication: Stribild
Dosage: 150-150-200-300 mg
Type: Prescription
Frequency: Daily, with meal in the mornings.
Reason: HIV, Antiretroviral

Medication: Amiodipine
Dosage: 2.5-10 mg
Frequency: Daily, with meal in the mornings.
Type: Prescription
Reason: High blood pressure

Medication: Zoloft
Dosage: 25 mg
Frequency: Daily, with meal in the mornings.
Type: Prescription
Reason: Depression

Physicians

Name: Dr. Robert Houghton
Specialty: Primary Care Physician, HIV Specialist
Office Phone #: 619-233-4044 United States

Insurance

Provider: CIGNA
ID Number: U4907236201
Group Number: 4700122

Additional Contacts

Name: Jerry Hall
Relationship: Father
Cell Phone #: 541-778-2694 United States
Notes: DO NOT DISCLOSE HIV STATUS!!!

Name: Curtis Taylor
Relationship: Friend
Cell Phone #: 619-813-6289 United States
Notes: San Diego contact with KEY to home, will be able to care for PETS.

Name: Albert Nava
Relationship: Employer
Cell Phone #: 602-909-7262 United States
Home Phone #: 480-283-0271 United States
Office Phone #: 480-990-9090 United States
Notes: DO NOT DISCLOSE HIV STATUS!!

Name: Patrick McCullough
Relationship: Friend
Cell Phone #: 602-405-7150 United States
Notes: ONLY contact if I am deceased.