It would be appreciated if you could provide the following information in written form:

1. Work history- Name of employer, dates of employment and your job position(s) for the last 15 years.
2. Medications- Name of medication, dosage, name of doctor, what the medication is for and any side effects you suffer as a result of taking the medication.
3. Name address and phone number of the doctors and hospitals that you have gone to in the last five years.