AUTHORIZATION

I, , GIVE PERMISSION TO THE LAW OFFICE OF ROSENBAUM AND ASSOCIATES, TO SET UP A CLAIM AND OBTAIN MY MEDICARE INFORMATION FOR THIS CLAIM FROM THE MY MEDICARE PORTAL FOR THE DURATION OF THIS CLAIM FOR THE ACCIDENT OF .
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Document name: Medicare Portal Authorization - Sam Lee

Unique Document ID: 98386e5fcef5a3db55b0744881ea8d4f93be6f9d

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Timestamp	Audit
May 19, 2020 4:41 am GMT	Medicare Portal Authorization - Sam Lee Uploaded by David Rosenbaum - test@rosenbaumfirm.com IP 68.80.162.82
May 21, 2020 12:07 am GMT	Sam Lee - slee@rosenbaumfirm.com added by David Rosenbaum - test@rosenbaumfirm.com as a CC'd Recipient Ip: 68.80.162.82
May 21, 2020 4:29 am GMT	Sam Lee - slee@rosenbaumfirm.com added by David Rosenbaum - test@rosenbaumfirm.com as a CC'd Recipient Ip: 68.80.162.82
May 21, 2020 4:49 am GMT	Sam Lee - slee@rosenbaumfirm.com added by David Rosenbaum - test@rosenbaumfirm.com as a CC'd Recipient Ip: 68.80.162.82

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https://www.rosenbauminjuryfirm.com/

Audit Trail Serial# 78d6c7fb8d267494b06be0df1bcd121b