PTO Form 1963 (Rev 5/2006)
`
`OMB No. 0651-0055 (Exp 12/31/2011)
`
`Combined Declaration of Use and/or Excusable Nonuse/Application for Renewal of
`Registration of a Mark under Sections 8 & 9
`
`The table below presents the data as entered.
`
`Entered
`
`Input Field
`
`REGISTRATION
`NUMBER
`
`REGISTRATION
`DATE
`
`1614853
`
`09/25/1990
`
`SERIAL NUMBER
`
`74016481
`
`MARK SECTION
`
`MARK
`
`MAYO CLINIC
`
`OWNER SECTION (current)
`
`NAME
`
`CITY
`
`STATE
`
`MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH
`
`ROCHESTER
`
`Minnesota
`
`ZIP/POSTAL CODE
`
`55905
`
`COUNTRY
`
`United States
`
`OWNER SECTION (proposed)
`
`NAME
`
`STREET
`
`CITY
`
`STATE
`
`MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH
`
`200 First Street SW
`
`ROCHESTER
`
`Minnesota
`
`ZIP/POSTAL CODE
`
`55905
`
`COUNTRY
`
`United States
`
`ATTORNEY SECTION (current)
`
`NAME
`
`FIRM NAME
`
`Elizabeth C. Buckingham
`
`DORSEY & WHITNEY L.L.P.
`
`INTERNAL ADDRESS
`
`220 SOUTH SIXTH STREET
`
`STREET
`
`CITY
`
`STATE
`
`POSTAL CODE
`
`COUNTRY
`
`PILLSBURY CENTER SOUTH
`
`MINNEAPOLIS
`
`Minnesota
`
`55402
`
`United States
`
`ATTORNEY SECTION (proposed)
`
`NAME
`
`Kari B. Frank
`
`

`
`FIRM NAME
`
`DORSEY & WHITNEY LLP
`
`INTERNAL ADDRESS
`
`Suite 1500
`
`STREET
`
`CITY
`
`STATE
`
`POSTAL CODE
`
`COUNTRY
`
`PHONE
`
`FAX
`
`EMAIL
`
`AUTHORIZED TO
`COMMUNICATE VIA E-
`MAIL
`
`ATTORNEY DOCKET
`NUMBER
`
`OTHER APPOINTED
`ATTORNEY
`
`50 South Sixth Street
`
`MINNEAPOLIS
`
`Minnesota
`
`55402-1498
`
`United States
`
`(612) 492-6863
`
`(612) 340-8856
`
`ip.docket@dorsey.com
`
`Yes
`
`11,376
`
`Stuart R. Hemphill, Elizabeth C. Buckingham, Jamie Nafziger, Patchen M. Haggerty, Jeffrey R.
`Cadwell, and Kelcey Patrick-Ferree
`
`GOODS AND/OR SERVICES SECTION
`
`INTERNATIONAL CLASS
`
`016
`
`GOODS OR SERVICES
`
`KEEP ALL LISTED
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)SPECIMEN FILE NAME(S)
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)ORIGINAL PDF FILE
`
`SPN0-1701121251-174510833_._11376_20845_20854_Specimen_for_8___15___Renewal.pdf
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)CONVERTED PDF
`FILE(S)
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(1 page)
`
`\\TICRS\EXPORT8\IMAGEOUT8\740\164\74016481\xml1\S890002.JPG
`
`SPECIMEN DESCRIPTION image of Registrant's health care newsletter bearing the mark
`
`INTERNATIONAL CLASS
`
`041
`
`GOODS OR SERVICES
`
`KEEP ALL LISTED
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)SPECIMEN FILE NAME(S)
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)ORIGINAL PDF FILE
`
`SPN1-1701121251-174510833_._11376_20852_20855_Specimen_for_8___15_and_Renewal.pdf
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)CONVERTED PDF
`FILE(S)
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(1 page)
`
`\\TICRS\EXPORT8\IMAGEOUT8\740\164\74016481\xml1\S890003.JPG
`
`SPECIMEN DESCRIPTION image of a page from Registrant's website advertising the services
`
`INTERNATIONAL CLASS
`
`042
`
`GOODS OR SERVICES TO
`BE DELETED
`
`GOODS OR SERVICES IN
`USE IN COMMERCE OR
`FOR WHICH OWNER
`CLAIMS EXCUSABLE
`NONUSE
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)SPECIMEN FILE NAME(S)
`
`health care services in the nature of a health maintenance organization
`
`medical and health care services, namely clinical services, physician services, pharmacy services,
`medical laboratory and testing services, and nursing care services; hospital services
`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)ORIGINAL PDF FILE
`
`SPN2-1701121251-174510833_._11376_20856_Class_42_Specimen_for_8___15_and_Renewal.pdf
`
`

`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)CONVERTED PDF
`FILE(S)
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(1 page)
`
`\\TICRS\EXPORT8\IMAGEOUT8\740\164\74016481\xml1\S890004.JPG
`
`SPECIMEN DESCRIPTION image of a page from Registrant's website advertising the services
`
`PAYMENT SECTION
`
`NUMBER OF CLASSES
`
`NUMBER OF CLASSES
`PAID
`
`SUBTOTAL AMOUNT
`
`TOTAL FEE PAID
`
`3
`
`3
`
`1500
`
`1500
`
`SIGNATURE SECTION
`
`SIGNATURE
`
`/daniel s goldman/
`
`SIGNATORY'S NAME
`
`Daniel S. Goldman
`
`SIGNATORY'S POSITION Assistant Secretary
`
`DATE SIGNED
`
`11/23/2009
`
`PAYMENT METHOD
`
`DA
`
`SUBMIT DATE
`
`Mon Nov 23 16:45:18 EST 2009
`
`FILING INFORMATION
`
`TEAS STAMP
`
`USPTO/S08N09-XXX.XXX.X.XX
`X-20091123164518668555-16
`14853-460a1de11677cf9cb8b
`20e48bba689214b0-DA-3730-
`20091120174510833123
`
`

`
`PTO Form 1963 (Rev 5/2006)
`
`OMB No. 0651-0055 (Exp 12/31/2011)
`
`Combined Declaration of Use and/or Excusable Nonuse/Application for Renewal of Registration of a Mark under
`Sections 8 & 9
`
`To the Commissioner for Trademarks:
`
`REGISTRATION NUMBER:(cid:160)1614853
`REGISTRATION DATE:(cid:160)09/25/1990
`
`MARK: (cid:160)MAYO CLINIC
`
`The owner, MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH, having an address of
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)200 First Street SW
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)ROCHESTER, Minnesota 55905
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)United States
`is filing a Combined Declaration of Use and/or Excusable Nonuse/Application for Renewal of Registration of a Mark under Sections 8 & 9.
`
`For International Class 016, the mark is in use in commerce on or in connection with all goods or services listed in the existing registration for
`this specific class; or, the owner is making the listed excusable nonuse claim.
`
`The owner is submitting one specimen showing the mark as used in commerce on or in connection with any item in this class, consisting of a(n)
`image of Registrant's health care newsletter bearing the mark.
`
`Original PDF file:
`SPN0-1701121251-174510833_._11376_20845_20854_Specimen_for_8___15___Renewal.pdf
`Converted PDF file(s) (1 page)
`Specimen File1
`
`For International Class 041, the mark is in use in commerce on or in connection with all goods or services listed in the existing registration for
`this specific class; or, the owner is making the listed excusable nonuse claim.
`
`The owner is submitting one specimen showing the mark as used in commerce on or in connection with any item in this class, consisting of a(n)
`image of a page from Registrant's website advertising the services.
`
`Original PDF file:
`SPN1-1701121251-174510833_._11376_20852_20855_Specimen_for_8___15_and_Renewal.pdf
`Converted PDF file(s) (1 page)
`Specimen File1
`
`For International Class 042, this filing does NOT cover the following goods or services for this specific class listed in the registration, and these
`goods or services are to be permanently deleted from the registration: (cid:160)health care services in the nature of a health maintenance organization
`
`The mark is in use in commerce on or in connection with the following goods or services listed in the existing registration for this specific class;
`or, the owner is making the listed excusable nonuse claim: medical and health care services, namely clinical services, physician services,
`pharmacy services, medical laboratory and testing services, and nursing care services; hospital services
`
`The owner is submitting one specimen showing the mark as used in commerce on or in connection with any item in this class, consisting of a(n)
`image of a page from Registrant's website advertising the services.
`
`Original PDF file:
`SPN2-1701121251-174510833_._11376_20856_Class_42_Specimen_for_8___15_and_Renewal.pdf
`Converted PDF file(s) (1 page)
`Specimen File1
`
`The registrant hereby appoints Kari B. Frank and Stuart R. Hemphill, Elizabeth C. Buckingham, Jamie Nafziger, Patchen M. Haggerty, Jeffrey R.
`Cadwell, and Kelcey Patrick-Ferree of (cid:160)DORSEY & WHITNEY LLP
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Suite 1500
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)50 South Sixth Street
`
`

`
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)MINNEAPOLIS, Minnesota 55402-1498
`(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160) United States
`to file this Combined Declaration of Use and/or Excusable Nonuse/Application for Renewal of Registration of a Mark under Sections 8 & 9 on
`behalf of the registrant. (cid:160)The attorney docket/reference number is 11,376.
`
`A fee payment in the amount of $1500 will be submitted with the form, representing payment for 3 class(es), plus any additional grace period
`fee, if necessary.
`
`Declaration
`
`Section 8: Declaration of Use in Commerce
`Unless the owner has specifically claimed excusable nonuse, the mark is in use in commerce on or in connection with the goods and/or services
`identified above, as evidenced by the attached specimen(s) showing the mark as used in commerce.
`
`Section 9: Application for Renewal
`The registrant requests that the registration be renewed for the goods and/or services identified above.
`
`The undersigned being hereby warned that willful false statements and the like are punishable by fine or imprisonment, or both, under 18 U.S.C.
`Section 1001, and that such willful false statements and the like may jeopardize the validity of this document, declares that he/she is properly
`authorized to execute this document on behalf of the Owner; and all statements made of his/her own knowledge are true and that all statements
`made on information and belief are believed to be true.
`
`Signature: /daniel s goldman/(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)(cid:160)Date: 11/23/2009
`Signatory's Name: Daniel S. Goldman
`Signatory's Position: Assistant Secretary
`
`Mailing Address (current):
`(cid:160)(cid:160)(cid:160)DORSEY & WHITNEY L.L.P.
`(cid:160)(cid:160)(cid:160)PILLSBURY CENTER SOUTH
`(cid:160)(cid:160)(cid:160)MINNEAPOLIS, Minnesota 55402
`
`Mailing Address (proposed):
`(cid:160)(cid:160)(cid:160)DORSEY & WHITNEY LLP
`(cid:160)(cid:160)(cid:160)50 South Sixth Street
`(cid:160)(cid:160)(cid:160)MINNEAPOLIS, Minnesota 55402-1498
`
`Serial Number: 74016481
`Internet Transmission Date: Mon Nov 23 16:45:18 EST 2009
`TEAS Stamp: USPTO/S08N09-XXX.XXX.X.XXX-2009112316451
`8668555-1614853-460a1de11677cf9cb8b20e48
`bba689214b0-DA-3730-20091120174510833123
`
`

`
`[W MAYO CLINIC
`MAYO CLINIC WOMEN'S
`HEALTH SOURCE
`
`May 2009
`Volmne I3, Nmnber 5
`
`TOOLS FOR HEALTHIER LIVES
`
`MEDICATION MISTAKES
`
`A Few Common
`
`Drug Interactions
`
`How to Avoid Dangerous Drug Errors
`
`If you take any type
`of medication, you're
`in good company.
`‘,1 Four out of five
`
`_ adults in the United
`States regularly take
`at least one prescrip-
`tion or over—the-
`
`counter (OTC) drug,
`according to a recent
`report in the Iourmzl
`of the Amerimu
`Medical Associat1'on.
`In addition, almost
`
`30 percent of older
`Americans use at
`
`_
`
`. _
`=-?f:
`
`least five prescrip-
`tions, and about half
`take OTC drugs or
`" 4 dietary supplements.
`There's no ques-
`tion that medications
`:'
`' can be beneficial. Yet
`it's important to re-
`):-? member that some
`,1
`risks do exist. In fact,
`‘
`the more medications
`
`_
`
`'33
`
`at -L--551Qua.
`
`oi »tn:ea:_s‘ili;ii:';
`.-»-4
`
`'6
`
`you use, the more important it is to take
`precautions to protect your safety.
`Below are some of the most common
`
`mistakes you can make when taking
`medications — and what you can do to
`avoid them.
`
`Not knowing key information
`
`If all you know about your medication
`is that you take the little blue pill with
`each meal and two white pills before
`bed time, you could be courting trouble.
`Although it's important to know what
`your medications look like and when to
`take them, you should also be aware of
`
`other information that can affect your
`well—being. This includes what you're
`taking (the drug name), why you're tak-
`ing it (the drug's purpose), how much
`you need (the current dosage), what kind
`of results you can expect, what side
`effects can occur or should be reported,
`and how this medication might interact
`with other drugs, food or beverages.
`Much of the information you need
`should be listed on the label and the
`
`information sheets that come with your
`medications. But that doesn't mean
`
`you’re on your own. if there's anything
`you don’t understand or want clarified,
`ask your doctor or pharmacist to go over
`the basics or answer specific questions.
`Keeping an updated list of all your
`medications also can help you stay on
`top of key information, and catch errors
`that may occur when you refill or get
`new prescriptions. Ideally, you should
`keep one copy of this list at home and
`one copy in your purse or wallet. You
`may also Want to consider keeping this
`list in an electronic health record you
`can access from your computer or the
`Internet, and make it available to family
`members, doctors and others involved
`
`in your health care.
`
`Miulng or sklpplng doses
`
`It can be easy to miss a dose of medica-
`tion on occasion. But if you're regularly
`forgetting to take certain drugs because
`the instructions are too difficult to fol-
`
`low, or are purposely skipping doses to
`save money, you're not likely to get the
`full benefit of your medication. If you
`want to see about simplifying a chal-
`lenging medication schedule, talk with
`your doctor. He or she may be able to
`
`

`
`Mayo Medical School
`
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`
`1
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`HOME
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`and now I see
`how I could do that
`how this dream could come true."
`more...
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`In The News
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`Study Finding Significant Shift in Reason
`for Tonsillectomies
`read the full stag...
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`"Combined, the two
`degrees enable you
`to reach from the
`bedside to the
`government bodies
`.
`and corporate
`boardrooms that shape our ability to
`provide medical care." more...
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`htt://WWw.ma 0.edu/rnms/
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`1 1/6/2009
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`

`
`8625 Overview: Heavy Metals Screen, Blood
`
`Page 1 of 1
`
`Mobile Site >
`
`MBYO Mfldlcll I-flh°'3t|"'°5
`
`MayolxieuicaiLauoialories,wrn
`Web‘
`rnml@mayu.edu
`Email,
`sun 533 1710
`Telephone:
`International: 5E7 266 5700
`Values are -/alto‘ only on day of printing
`
`Unit Code 8625:
`
`Heavy Metals Screen, Blood
`Profile Information
`
`Available Separately Always Performed
`Unit Code Reporting Name
`18064
`Heavy Metals Screen, B No
`Yes
`2541
`Arsenic
`Yes (order #8645)
`Yes
`2588
`Lead
`Yes (order #8602)
`Yes
`2589
`Mercury
`Yes (order #8618)
`Yes
`2655
`Cadmium
`Yes (order#8682)
`Yes
`
`Special Instructions and Forms
`- Metals Analysis - Collection and Transport
`
`Method Name
`
`Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
`NOTE: Mayo Medical Laboratories offers both an essential
`elements screen and a heavy metals screen. In the case
`when a metals screen is ordered, we will assume this to
`be a heavy metals screen request. In case we have
`misinterpreted your request. the specimen will be retained
`for 2 weeks following testing, during which time you may
`call and request other testing.
`
`Reporting Name
`Heavy Metals Screen, B
`
`Ordering Mnemonic
`HMSB
`
`Aliases
`
`Arsenic (As)
`As (Arsenic)
`Cadmium (Cd)
`Cd (Cadmium)
`Heavy Metals
`Heavy Metals Screen, Blood
`Hg (Mercury)
`Lead (Pb)
`Mercury (Hg)
`Metals Screen
`Pb (Lead)
`Soft-HMSB
`
`htt://ma omedicallaboratories.co1n/test—cata1o
`
`r
`
`«"
`
`11/20/2009
`
`

`
`ROUTING SHEET TO POST REGISTRATION (PRU)
`
`Registration Number?
`
`1614353
`
`Serial Number:
`
`74016481
`
`RAM Sale Number: 3730
`
`RAM Accounting Date: 20091124
`
`Total Fees:
`
`$1500
`
`Note: Process in accordance with Post Registration Standard Operating Procedure (SOP)
`
`Transaction
`
`Transaction
`Date
`
`Fee per
`Class
`
`Number
`of Classes
`
`Number of
`Classes Paid
`
`§8 affidavit
`Application for Renewal (§9)
`
`20091123
`20091 123
`
`$100
`$400
`
`Physical Location: 900 - FILE REPOSITORY (FRANCONIA)
`
`Lost Case Flag: False
`
`In TICRS (AM—FLG—IN—TICRS): True
`
`Transaction Date:
`
`20091123