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Form 8853 Lansing Michigan: What You Should Know

Citizens for a Healthy Lifestyle DIAZ Communications 2071 W. Washington St. Chicago, IL 60614 MARKETING/SPONSORS Kraft Foods, Inc. Founded in 1893, Kraft Foods is one of the world's leading food, dairy and cooking supplies companies. Mason's, Inc. In 2005, Mason's purchased The Land O' Lakes Hotel at the corner of W. Jefferson Street and W. Michigan Avenue in Chicago, for 26 million. Purdue Pharma L.P. Purdue Pharma, based in New York City, is the world's leading supplier of a variety of prescription drugs. Purdue has more than 8,000 U.S. employees and an annual sales volume of about 20 billion. Kensington Properties, LP Kensington is a leading multi-family residential developer with a focus on downtown residential properties, located in Chicago, Illinois. It is also the owner and operator of The Land O' Lakes. WILLIAMSON DIABETES In 2015, the state of Michigan passed a law (Form 8582) to ensure the highest standard of care for terminally ill patients. This act does not replace the responsibilities and services offered by a patient's primary care physician. Please refer to the patient's primary care physician for instructions on how to access the medical care and treatment provided by their care team. If you need any assistance related to this form please contact us for assistance. This form can be used for purposes of obtaining your healthcare provider for medical claims. If you have a question about or need more documentation of this form to confirm the information below, contact the Michigan Department of Licensing and Regulatory Affairs at in writing or call, anytime. If you are a Michigan patient or patient's family member or caregiver you can call, to request a new request form, which will include the following information to verify that you are actually an eligible patient. If you can't find your request form, please refer to your information below. • Medical care documentation provided by your care team for your case. • Name, address, and date of birth of your care team. • Identification number, if you choose to provide it.

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