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Case Log/Activity Profile Requests

 

 

Please note we are able to provide case logs for physicians only.  We are able to provide a copy of the most recently approved privileges for all provider types.

 

            All requests for practitioner case logs must be submitted using one of the following:

  • Direct email from the practitioner authorizing release of case logs to the practitioner or to a specific healthcare entity.
  • Email from the requesting healthcare entity with a copy of the signed release from the practitioner (address to medicalstaffservices@umassmemorial.org)
  • Fax from the requesting healthcare entity with a copy of the signed release from the practitioner (faxed to 508-334-8235)

 

What will be provided:

  • A listing of the name of the procedure performed and the number of times the procedure has been performed for the requested time period.
  • A copy of the most recently approved delineation of privileges.

 

Response Time:

  • Given the number of requests we receive, please allow 3 business days for a response.  Your request will be answered sooner whenever possible.