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.