Tracking Details - #3315

Tracking Information
Case No: 3129
Order Date: 01/29/2026
Due Date:
Template Packet: New York HIPAA Authorization Packet
Scope:
Location: 1199SEIU Funds Headquarters
330 West 42nd Street
New York, NY 10036
Phone: 646-473-8956 • Fax: Records.Retention@1199Funds.org
Patient: Hugh Jackman
DOB: 11/11/1950 • SSN: ***-**-4516
1199SEIU Funds Headquarters
330 West 42nd Street
New York, NY 10036
Phone: 646-473-8956 • Fax: Records.Retention@1199Funds.org
Current packet matches the recommended template: New York HIPAA Authorization Packet.
Hugh Jackman
DOB: 11/11/1950 • SSN: ***-**-4516
Requested Records
Record Status
Billing Pending
Medical Pending
File Name Uploaded Date Uploaded By
No documents found.
Tracking Step Log
Step Due Date Remarks Publish Entered
Received Order, In Progress Yes 1/29/2026 11:57 PM
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