Owners Statement

Annapolis ENT Surgical Center

The purpose of this notice is to inform you that Gregory L. Heacock, M.D., J. Michael Pardo, M.D., Joydeep Som, M.D., Matthew Hilburn, M.D., Annalisa Overstreet, M.D., Peter King, M.D. and Bryan Ambro, M.D. of this Practice indirectly own Annapolis ENT Surgical Center whose purpose is to manage and operate a surgery center located at 2002 Medical Parkway Ste. 150 Annapolis, Maryland. These physicians are all certified by the American Board of Otolaryngology, licensed in the state of Maryland, and on staff at Anne Arundel Medical Center.

By this Notice, the above named Physicians disclose the existence of the ownership of a business interest in Annapolis ENT Surgical Center. Under Maryland law, this statement must inform you that you may choose to obtain health care services from another health care facility. Maryland law further requires that you acknowledge in writing the receipt of the above statement.