Tracking Details - #126

Tracking Information
Case No: 79
Order Date: 09/03/2025
Due Date:
Template Packet: HIPAA Authorization Packet
Scope:
Location: Cleveland Clinic Weston Hospital
c/o Health Information Dept. - Medical, Billing, Imaging 3100 Weston Rd
Weston, FL 33331
Phone: (954) 689-5110/(954) 659-5000 • Fax: WESTONRADLEGALFAX@CCF.ORG
Patient: Joaquin Phoenix
DOB: 01/12/2007 • SSN: ***-**-3984
Cleveland Clinic Weston Hospital
c/o Health Information Dept. - Medical, Billing, Imaging 3100 Weston Rd
Weston, FL 33331
Phone: (954) 689-5110/(954) 659-5000 • Fax: WESTONRADLEGALFAX@CCF.ORG
Recommended for this case: New York HIPAA Authorization Packet via PacketTemplateDefault (LegacyDefault).
Joaquin Phoenix
DOB: 01/12/2007 • SSN: ***-**-3984
Requested Records
Record Status
Billing Fulfilled
Medical Fulfilled
File Name Uploaded Date Uploaded By
HIPAA_Authorization_126_20250903165310.pdf 2025-09-03
Tracking Step Log
Step Due Date Remarks Publish Entered
Received Order, In Progress Yes 9/3/2025 4:52 PM
Generation Dept - Printed Packet 9/3/2025 Yes 9/3/2025 8:53 PM
FedEx to Custodian FedEx label created. Tracking=N/A; Path=N/A; Error=PHONENUMBER.TOO.LONG: We are not able to retrieve the message for the warning or error. | STREETLINES.TOO.LONG: We are not able to retrieve the message for the warning or error. No 9/8/2025 1:08 PM
Assigned To: 10/27/2025 Assigned To: UserNo=1005 [INITIAL] No 10/25/2025 8:49 PM
Delivered to custodian (carrier confirmed) 10/25/2025 Delivered (manual) No 10/25/2025 8:49 PM
Emailed Request to Custodian Emailed Request Packet to joeperri89@gmail.com (RequestNo 1097) Yes 12/2/2025 12:07 AM
Received - Portion of Records Received - Portion of Records Yes 2/26/2026 8:38 PM
Received - All Records Received - Records Yes 2/26/2026 9:18 PM
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