Tracking Details - #74

Tracking Information
Case No: 50
Order Date: 07/31/2025
Due Date: 09/16/2025
Template Packet: HIPAA Authorization Packet
Scope:
Location: Dr. Timothy Growth
994 West Jericho Turnpike
Smithtown, NY 11787
Phone: None • Fax: None
Patient: Margot Robbie
DOB: 02/24/1963 • SSN: ***-**-9278
Dr. Timothy Growth
994 West Jericho Turnpike
Smithtown, NY 11787
Phone: None • Fax: None
Margot Robbie
DOB: 02/24/1963 • SSN: ***-**-9278
Requested Records
Record Status
Billing Pending
Films Pending
Medical Pending
File Name Uploaded Date Uploaded By
HIPAA_Authorization_74_20251003165324.pdf 2025-10-03
Tracking Step Log
Step Due Date Remarks Publish Entered
Received Order, In Progress Yes 7/31/2025 9:19 PM
Generation Dept - Printed Packet 10/3/2025 Yes 10/3/2025 8:53 PM
Fax sent 1/30/2026 No 1/30/2026 2:15 AM
Fax delivery confirmed 2/3/2026 Fax delivered (manual) No 2/3/2026 12:32 AM
Assigned To: 2/5/2026 Assigned To: UserNo=1005 [INITIAL] No 2/3/2026 12:32 AM
Called Facility 3/9/2026 Called Dr. Timothy Growth at None. Facility staff advised sending info today. Yes 3/2/2026 4:17 PM
Fax sent 3/2/2026 Fax sent [RC:2955817992007] Yes 3/2/2026 4:17 PM
Sent Custodian additional Fax of Request Packet 3/9/2026 Faxed Request Packet to 2122131715 (RequestNo 2157) Yes 3/2/2026 4:17 PM
Assigned To: 3/11/2026 Assigned To: UserNo=1005 [INITIAL] No 3/9/2026 2:33 AM
Loading request packet...