Exhibit,Appendix: J F an Infant, by GINA FAMA, as Mother and Natural Guardian, Gina Fama Individually, Joseph J Fama Individually v. Irwin Goldstein M.D., Long Island Ob/Gyn Associates, South Nassau Communities Hospital

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                                FILED:         NASSAU        COUNTY         CLERK        02/08/2016             11:42       AM                      INDEX    NO.   607047/2015
   NYSCEF     DOC.   NO.   20                                                                                 RECEIVED      NYSCEF:     02/08/2016
                               Request for Judicial Intervention Addendum                                                       UCS-840A (7/2012)


      Nassau Supreme COURT, COUNTY OF Nassau                                                                Index No:     607047/2015
      For use when additional space is needed to provide party or related case information.

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              Parties:                             Attorneys and/or Unrepresented Litigants:

               List parties in caption order and indicate                                                          Issue
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               party role(s) (e.g., defendant; 3rd-party                                                          Joined
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               plaintiff).                         unrepresented litigants, provide address, phone number and e-mail address.
                                                                                                                  (Y/N):

              Name: SOUTH NASSAU COMMUNITIES       ROBERT BETZ, Connick, Myers, Haas & McNamee, PLLC, 114 Old Country
              HOSPITAL                             Road, Ste. 208 , MINEOLA, NY 11501, 5168733900, cmhm@cmhmlaw.com
       ☐      Role(s): Defendant/Respondent
                                                                                                                    YES




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