IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF COLORADO

Chief Judge Marcia S. Krieger

Civil Action No. 15-cv-01964-MSK-NYW

KELSEY OLDERSHAW, individually and on behalf of others similarly situated,

ELINA NAVARRO;
JANE STANT;
JAYMIE STEVENS;
DENISE LANDIN;
ARCANDRICE RATCLIFF; and
GEORGIA HAMREN,

Plaintiffs,

v.

DAVITA HEALTHCARE PARTNERS, INC.; and

TOTAL RENAL CARE INC.,

Defendants.

CONSENT TO JOIN

I WANT TO JOIN THE LAWSUIT, Oldershaw, et al., v. DaVita Healthcare Partners, Inc., et al., and assert
claims arising under the Fair Labor Standards Act against Defendants DaVita Healthcare Partners, Inc. and Total
Renal Care, Inc.

(PLEASE CHECK ONLY ONE BOX)

I choose to be represented by the attorneys at Ramos Law, LLC Colleen T. Calandra, Jessica L.
Derakhshanian, and other attorneys with whom they may associate for purposes of this lawsuit. I intend to
enter into a separate agreement with Ramos Law, LLC regarding the terms of such representation,
including defining the scope of representation, the extent to which I will participate in this lawsuit, and
the compensation to be paid to Ramos Law, LLC.

I choose to be represented by attorney ____________________________________________________

of the law firm of ________________________________________________________, whose address is
_______________________________________________________, and whose telephone number is
________________________________. I understand and agree that I will be responsible for all costs and
attorneys fees incurred in pursuing my claim; OR

I choose to represent myself. I understand and agree that I will be responsible for all costs and fees
incurred in pursuing my claim.

Date: ___________________ Signed: _____________________________________

_____________________________________
Printed Name