Elizabeth Manning

 
 From: XcBee Records. LLC Fax: 
 To: 
 Fax: (863) 682xxxx 
 Page: 1 of 14
 Jan 08, 2020 11:03 AM 
 2nd attempt Oct 27, 2023 
 Please confirm once received at ccenina@xebee.com/ 720xxxxxxx 
 XeBee Records 
 4475 E. 74th Ave., Suite 203 
 Commerce City, CO 80022 
 XeBee 
 Phone: 855xxxxxxx 
 records 
 Fax: 866xxxxxxx
 REQUEST ID: 617114 
 New Hope Chiropractic Center 
 4788 South Florida Ave. 
 DATE of REQUEST: Jan 08, 2020
 Lakeland, FL 33813 
 Phone: (863) 682xxxx 
 Fax: (863) 682xxxx 
 emailed 
 REQUEST FOR: 
 Medical Records and Itemized Billing Statements 
 ff Jan 08, 2020 
 We are requesting materials on behalf of Abrahamson and Uiterwyk for the following individual: 
 Patient: Witter, Grace 
 Date of Birth: 
 Dec 13, 2003 
 Alias/AKA: 
 Date of Death: 
 DATES OF SERVICE: May 28, 2018 to Present 
 Instructions: 
 Please send all medical records and itemized billing (including CMS-1500/UB-04 forms) for the time period above. 

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 These documents contain confidential information that is legally protected under federal HIPAA law. If you are not the 
 intended recipient please contact us immediately.
