| Contact Information | |
|---|---|
| First Name | Heather |
| Last Name | Medina |
| Address | 525 Cotton St |
| City | Brush |
| State | CO |
| Province | |
| Zip/Postal Code | 80723 |
| Country | United States |
| Home Phone | 970 - 842-4436 |
| Work Phone | 970 - 867-9471 |
| Fax | |
| medinaheather@hotmail.com | |
| Alternate Email | |
| Website Address | |
| Gender | Female |
| Injury Information | |
| The injured person is | Child |
| Name of Injured | Angelis - Medina |
| Date of Injury | 05-04-2002 |
| Type of Injury | Obstetric |