%PDF-1.6
%
3 0 obj
<>/P 4 0 R/T(internalData)/V(formNo=36138&fac=RR&Forms.footer.formid=36138&Message.time=11:05:37&Forms.time=11:05:37&fac=RR&Referrals.date=08/15/2019&requestId=lrpformap10.medctr.ucla.edu_10.246.4.202_1565892337804&Message.submittedBy=Eleanor OBrien&Message.footer.formid=36138&Referrals.submittedBy=Eleanor OBrien&Forms.date=08/15/2019&submitURL=submitForm&Referrals.footer.formid=36138&footerFormID=36138&formNo=36138&Forms.submittedBy=Eleanor OBrien&Message.date=08/15/2019&facility=RR&Referrals.time=11:05:37)/DA(/Helv 0 Tf 0 g )/Rect[0 0 100 20]/Ff 0/Subtype/Widget/Type/Annot/F 6/FT/Tx/DR<>>>/AP<>>>
endobj
2 0 obj
<>
endobj
1 0 obj
<>>>/BBox[0 0 100 20]/Length 297>>stream
xMO0O\Ҥ_K'R(b*8֝)bNe&|_;>90
0j5؏X}ia.vpS~n0[DXuh[2? urD5
Ɩ_~N,P)Yu$6mRxӫ\Tj?{FIyJA82?ySou5QʦUIr_g$;>>xMxTgU \Olcr̹J}{_ǩ٘
f_I
endstream
endobj
5 0 obj
<>
endobj
6 0 obj
<>stream
Microsoft Word - 36138_SCOI_ROI_July20196
marinalawson
endstream
endobj
7 0 obj
<>/ExtGState<>/ProcSet[/PDF/Text/ImageC]/Font<>/XObject<>>>/Annots 18 0 R/CropBox[0 0 612 792]/Parent 19 0 R/Rotate 0/MediaBox[0 0 612 792]>>
endobj
8 0 obj
<>stream
HWێ
}W@W5 (4 $@`ƷM`!YdUuw$'Q[frxH~=+5|j4x5!Z;*3{Oje顼l=Fe×_Ɓ'6|;|Q4]L.|xOU3C~]p9̵FԺjpGՇV4\fqdlikUcOMVˡ~ 9:C|4yTBr hݐ^3|y{84;:\oC~v>ѧ!?ngu{ԗP_Ov:jLABi3*Û18>GCjAJ
AT8LBntMcrdCFDA6lh,wrwՀg 1!L}/'!'"<=?Cjtny;a(N7;1Q=y}:kAuspS|h"|qnj6_chnd_¬Kr2rT# OI^W9CiyImB1!FCWXQ
ُ_
|?rNOg_}ϻ{| mZ;H8/nV2JP4@1KҨ4`^ )"
AhBfY
wpPKZB#ӹbS@asƟ?W#?ݏ о}
d6(d-2h,VcEkWxzj C{3p8LcEO7B%koTTxl篶Ǵl>[ȿmo.mgV)',KD6t>KUg/r98V+ĪdƚQ2-q(XB6ݾ@
Ru @-]0A{`/(*Xi1iD0]^c\u NQn1(ץ4sAty#\Dt8WyNOr
z79ݖDr2LD_(,
6"g'"J#.ba'˭kݥ2KR4TlK2O\]A95]`6ʙ"`8y}zb'62I ,eˀ315T+؇u6SEkRC1ծz,g҅jt8tvz|gXir\}!^ZUmbLS٦dAYl'K:rsf(vz]?uu,.uas|ц9*cJD{3;C$l 8gs WjaPrK
ٮ8]
0C_*ЗA}5rIɡ7u#ĝNځ%w
v4`MfB)7 50Yqڪ꣢h|BaO&=ғ]PHO:B%yX6qP͑bfF7 ]UOl'J`I6tl;oأk٨P+j
ŞbFzZYlv
UsMׅeMenjrha8x hxpS%
or<M+
,Dx:FzlVj+l,=:.șvgnCNMiI{>jVP KVLeT@ܵaHvfȘI,F8lDeV5ڐ&e2eƢ;%Hx3۩2]IˬCUC#8~)%^':>? d@pf[fnOvrǩ$R3MN
S$=3A6?֙#`J]3rer
h봽ap qn]n'wGͲ :/|D?
~
TΚMPVy[17q%תm(tgXSdնXhqfaZȀZil\H{fLRÜM-U*gUeJ2u)eBQV)`:Tܶ5gB7ȅꊘ,K0ߝt1#u}X^>h{,Y+6ض%
82iېYqE.OũHc(%m[1PwkTe;4f̕1iМ!E#4kZBh;S?E:Kt_aMaNg]h
AgGg
4Ĝvf٘X5N3]/Wlzg%+O&0¬n;B[w;8ʼ}liYD[=gBx4L=B?,gTҏׂ>xk(=#==Cv~/&_F>-jɠo3Il }La@~cj. /tcٶDZf8^^{XuE5v+ÌQt{Ц9%i<|X!H)p\/̤L]/r/M08֚q#C, YwYk_Masֵ`]ݐ^B1 m_Λ0G(_^)^aP6(įPTlk0UcCqo<&L@6WBS{Kލ7Z\ѩ[K&ϱٹ6(mD4KAT#V~oV2r _)ݢ,66V̘k#Eg`qsיq+3B~;55 M