Request,Application: Camalah Kopacz vs. Paul Speece, M.D.

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                                CIV-110
           ATTOANJiV OR PARTY WTHOUT ATTORNEY (Nan», Slalo Sar 11""1bar. and -4thuJ:
           Kat Todd                                              SBN: 223957                                     FOR COURT USE OM. Y
          SCHUERING ZIMMERMAN & DOYLE, LLP
          400 University, Sacramento, CA 9S825
                  TELEPHONE NO.: (916) 567•0400         FAX NO. (Opliona/J: (916) S68-0400
            E-MAIL ADDRESS (Optjot&t/J:                                                                E-FILED
                                                                                                       11/8/2021 1:54 PM
                               CLOVIS COMMUNITY MEDICAL CENTER
              ATTORNEY FOR (NIJrte}
                                                                                                       Superior Court of California
           SUPERIOR COURT OF CALIFORNIA, COUNTY OF FRESNO                                              County of Fresno
                  STREET AooRess I 130 O Street                                                        By: A. Ramos, Deputy
                  MAILtNa AOoRess 1130 O Street
                 CITY AND ZIP C0DE:Fresno, 93721-2220
                    BRANCHNAME:8.F. Sisk Courthouse
              PLAINTIFF/PETITIONER: MACIEJ KOPACZ, M.D. , el al.
          DEFENDANT/RESPONDENT: PAUL SPEECE, M.O., et al.

                                       REQUEST FOR DISMISSAL                                        CASE NUMBER: 21CECG02707

            A conformed copy will not be returned by the clerk unless a method of return ls provided with the document
            This form may not be used for dismissal of a der ivative action or a class action or of any party or cause of action in a
            class action. (Cal. Rules of Court, rules 3.760 and 3.770.)
          1. TO THE CLERK: Please dismiss this action as follows:
             a. (1)D'D  \Mth prejudice   (2) CJ    Wthout prejudice
             b. (1)CJ   Complaint         (2)D     Petition
               (3) D    Cross-complalnt filed by (name):                                               on (date):
               ( 4)D    Cros&-complaint filed by (name):                                               on (date):
               (5) CJ   Entire action of all parties and all causes of action
               (6) [X) Other (specify):• Second Cause of Action for lack of infonned consent ONLY as to Fresno Community Hospital &
                                         Med Center dba Clovis Comm. Med Center. Each party to bear their own costs and fees.
          2. (Complete In all cases except family law cases.)
             The court  D    did [X] did not waive court fees and costs for a party in this case.(This information may be obtained from
             the cleric. If cou,t fees and costs were waived, the declaration on the back oft
                                                                                           · fl rm mu  be completed).
          Date: [( ,O '(. \,"'''
           r>-'m•�r>.\. 1: ,�Mes
          (TYPE OR PAM NAME OF[X]
                                 .........................
                                   ATI'ORNEV c::J
                                                                   .
                                                   PARTY WITHOUT ATTORNEY)                                (SIGNATURE)
                                                                            Attorney or party wit
          •If dismlssal requested Is of specffled par!!es onf>t or specified causes of adlon      ut attorney for.
          cw,,or of�      omS&-COmJJfalnta onl'f,
                                             so stateand                     [X)
                                                         identify the partios.     Plalntiff/Petitioner    CJ     Defendant/Respondent
          causos of action. or crca&-e0mplatnts to be alsmlsaed.
                                                                            D      Cross-Complainant
          3. TO THE CLERK: Consent to the above dismissal is hereby given.­

                                                                               ►
             Date:

                              D ATTORNEY c:J P>mY WITHOUT ATTORNEY)
          (TYPE OR PRINT NAME OF                                                                          (SIGNATURE)

                                                                            Attorney or party without attorney for:
          - If a etoaS