Request #20-1819
  Closed

City of Miami Fire Dept.

1151 NW 7th Street

Miami, FL  33136

 

            Our Client(s): Fermina  C. Ortega    

            Date of Birth:  11/23/1974             Run# 2020-013027

            SS#:                 768‑05‑5829

            D/Accident:    5/29/2020

 

To Whom It May Concern:

 

The purpose of this letter is to request copies of any and all of Fermina  C. Ortega medical records for ONLY the date of 5/29/2020, the injury date, and treatments thereafter pertaining to the injury as allowed by the Health Insurance Portability and Accountability Act (HIPAA) and Department of Health and Human Services regulations. Enclosed is our client’s signed Medical Authorization.

 

I look forward to receiving the above records within 30 days as specified under HIPAA. If my request cannot be honored within 30 days, please inform me of this by letter as well as the date I might expect to receive my records. Please mail or fax the requested records to me at the information above.

We agree to pay for all reasonable expenses you incur in providing the above information upon receipt of same. Thank you for your attention to these requests.

 

Sincerely,

Alejandro Uriarte


Received

June 29, 2020 via web


Departments

Fire

Documents

Public

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Staff

Point of Contact

Alberto Diaz

Request Closed   Hide Public

The City does not have any responsive documents to this request. As such, this request is being closed. Not in City of Miami Limits - Please contact Hialeah Fire Rescue

July 13, 2020, 1:36pm
Department Assignment Public
Added: Fire.
June 29, 2020, 11:56am
Request Opened Public
Request received via web
June 29, 2020, 11:55am