clinic county clinic name clinic city clinic zip ... 2013 f… · bremer edeker, jennifer arnp -...

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Clinic County Clinic Name Clinic City Clinic Zip Participant County Participant Gender Enrollment Status Fax Received Date ADAIR PETERSON, CINDY - IAM ADAIR 50002 GREENE Female Accepted FC 9/9/2013 ADAMS HADDADIN, MAEN - IAM CORNING 50841 ADAMS Female Accepted FC 9/27/2013 APPANOOSE MCCONVILLE, VIRGINIA - IAM CENTERVILLE 52544 APPANOOSE Female Accepted FC 9/5/2013 APPANOOSE PARRISH, CASSIE ARNP - IAM CENTERVILLE 52544 APPANOOSE Not Asked Unreachable 9/23/2013 APPANOOSE PARRISH, CASSIE ARNP - IAM CENTERVILLE 52544 APPANOOSE Not Asked Unreachable 9/19/2013 APPANOOSE PARRISH, CASSIE ARNP - IAM CENTERVILLE 52544 APPANOOSE Not Asked Unreachable 9/20/2013 Benton MESCHER, DEB PAC - IAM BELL PLAINE BENTON Female Accepted FC 9/4/2013 BENTON MANGOLD, MARGARET MD - IAM VINTON 52349 BENTON Female Accepted FC 9/16/2013 BENTON MANGOLD, MARGARET MD - IAM VINTON 52349 BENTON Male Accepted FC 9/16/2013 BLACK HAWK IJAZ, KIRAN - IAM WATERLOO BLACK HAWK Female Accepted FC 9/10/2013 BLACK HAWK IJAZ, KIRAN - IAM WATERLOO BLACK HAWK Female Accepted FC 9/20/2013 BLACK HAWK IJAZ, KIRAN - IAM WATERLOO BLACK HAWK Male Accepted FC 9/16/2013 BLACK HAWK IJAZ, KIRAN - IAM WATERLOO BLACK HAWK Female Unreachable 9/3/2013 BLACK HAWK SADLER, HELEN - IAM WATERLOO BLACK HAWK Male Accepted FC 9/17/2013 BLACK HAWK AL-SELMIE, EMAN - IAM WATERLOO 50703 Not Asked Unreachable 9/18/2013 BLACK HAWK BAHLMANN, ESTHER - IAM WATERLOO 50703 BLACK HAWK Male Accepted FC 9/9/2013 BLACK HAWK BERRY, CARRIE ARNP - IAM WATERLOO 50703 BLACK HAWK Female Accepted FC 9/10/2013 BLACK HAWK BONTHIUS, HEIDI - IAM WATERLOO 50702 BLACK HAWK Female Accepted FC 9/13/2013 BLACK HAWK BONTHIUS, HEIDI - IAM WATERLOO 50702 BLACK HAWK Female Accepted FC 9/19/2013 BLACK HAWK BONTHIUS, HEIDI - IAM WATERLOO 50702 BLACK HAWK Female Accepted FC 9/23/2013 BLACK HAWK BONTHIUS, HEIDI - IAM WATERLOO 50702 BLACK HAWK Male Accepted FC 9/27/2013 BLACK HAWK BREITKREUZ, DAVID DR - IAM WATERLOO 50702 BLACK HAWK Female Accepted FC 9/9/2013 BLACK HAWK COVENANT CLINIC WATERLOO 50702 BLACK HAWK Not Asked Declined FC 9/19/2013 BLACK HAWK CUE, RHONDA - IAM WATERLOO 50702 BLACK HAWK Female Accepted FC 9/27/2013 BLACK HAWK DUCLOS, SHARON - IAM WATERLOO 50703 BLACK HAWK Female Accepted FC 9/3/2013 BLACK HAWK ENGHOLM, ISSAC DR - IAM WATERLOO 50702 BLACK HAWK Male Accepted FC 9/27/2013 BLACK HAWK ENGHOLM, ISSAC DR - IAM WATERLOO 50702 BLACK HAWK Not Asked Active 9/24/2013 BLACK HAWK FOENS, CASSANDRA DR - IAM WATERLOO 50702 BLACK HAWK Male Active 9/27/2013 BLACK HAWK HENDERSON, VICKI - IAM WATERLOO 50703 BLACK HAWK Male Accepted FC 9/19/2013 BLACK HAWK HENDERSON, VICKI - IAM WATERLOO 50703 BLACK HAWK Female Accepted FC 9/17/2013 BLACK HAWK HENDERSON, VICKI - IAM WATERLOO 50703 BLACK HAWK Female Accepted FC 9/4/2013 BLACK HAWK HENDERSON, VICKI - IAM WATERLOO 50703 BLACK HAWK Female Accepted FC 9/6/2013 BLACK HAWK KEENAN, MARY - IAM EVANSDALE 50707 BLACK HAWK Female Accepted FC 9/9/2013 BLACK HAWK LIES, MARILYN MD - IAM EVANSDALE 50707 BLACK HAWK Female Accepted FC 9/27/2013 BLACK HAWK LIES, MARILYN MD - IAM EVANSDALE 50707 BLACK HAWK Not Asked Active 9/27/2013 BLACK HAWK MENKEN, MEAGAN ARNP - IAM WATERLOO 50702 BLACK HAWK Not Asked Unreachable 9/6/2013 BLACK HAWK MONROE, ASHLEY ARNP - IAM WATERLOO 50701 BLACK HAWK Female Accepted FC 9/4/2013 BLACK HAWK MONROE, ASHLEY ARNP - IAM WATERLOO 50701 BREMER Male Accepted FC 9/25/2013 BLACK HAWK MORRIS, MEGHAN DR WATERLOO 50702 BLACK HAWK Male Accepted FC 9/17/2013 BLACK HAWK MUSTAFIC, LYDIA - IAM WATERLOO 50702 BLACK HAWK Not Asked Active 9/27/2013 BLACK HAWK OTTMAN, MELISSA ARNP - IAM WATERLOO 50703 BLACK HAWK Female Accepted FC 9/24/2013 BLACK HAWK PETERSON, JAMES - IAM CEDAR FALLS 50613 BLACK HAWK Male Accepted FC 9/24/2013 BLACK HAWK RIADZAKY, ALFONSE DR - IAM WATERLOO 50703 BUCHANAN Male Unreachable 9/10/2013 BLACK HAWK SANDELL, JULIE - IAM CEDAR FALLS 50613 BLACK HAWK Male Unreachable 9/6/2013 BLACK HAWK SANKEY, BRIAN DR - IAM WATERLOO 50702 BLACK HAWK Female Accepted FC 9/24/2013

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Page 1: Clinic County Clinic Name Clinic City Clinic Zip ... 2013 F… · BREMER EDEKER, JENNIFER ARNP - IAM DENVER 50622 BREMER Not Asked Unreachable 9/6/2013 BREMER WAVERLY HEALTH CENTER

Clinic County Clinic Name Clinic City Clinic Zip Participant

County

Participant

Gender

Enrollment Status Fax Received Date

ADAIR PETERSON, CINDY - IAM ADAIR 50002 GREENE Female Accepted FC 9/9/2013

ADAMS HADDADIN, MAEN - IAM CORNING 50841 ADAMS Female Accepted FC 9/27/2013

APPANOOSE MCCONVILLE, VIRGINIA - IAM CENTERVILLE 52544 APPANOOSE Female Accepted FC 9/5/2013

APPANOOSE PARRISH, CASSIE ARNP - IAM CENTERVILLE 52544 APPANOOSE Not Asked Unreachable 9/23/2013

APPANOOSE PARRISH, CASSIE ARNP - IAM CENTERVILLE 52544 APPANOOSE Not Asked Unreachable 9/19/2013

APPANOOSE PARRISH, CASSIE ARNP - IAM CENTERVILLE 52544 APPANOOSE Not Asked Unreachable 9/20/2013

Benton MESCHER, DEB PAC - IAM BELL PLAINE BENTON Female Accepted FC 9/4/2013

BENTON MANGOLD, MARGARET MD - IAM VINTON 52349 BENTON Female Accepted FC 9/16/2013

BENTON MANGOLD, MARGARET MD - IAM VINTON 52349 BENTON Male Accepted FC 9/16/2013

BLACK HAWK IJAZ, KIRAN - IAM WATERLOO BLACK HAWK Female Accepted FC 9/10/2013

BLACK HAWK IJAZ, KIRAN - IAM WATERLOO BLACK HAWK Female Accepted FC 9/20/2013

BLACK HAWK IJAZ, KIRAN - IAM WATERLOO BLACK HAWK Male Accepted FC 9/16/2013

BLACK HAWK IJAZ, KIRAN - IAM WATERLOO BLACK HAWK Female Unreachable 9/3/2013

BLACK HAWK SADLER, HELEN - IAM WATERLOO BLACK HAWK Male Accepted FC 9/17/2013

BLACK HAWK AL-SELMIE, EMAN - IAM WATERLOO 50703 Not Asked Unreachable 9/18/2013

BLACK HAWK BAHLMANN, ESTHER - IAM WATERLOO 50703 BLACK HAWK Male Accepted FC 9/9/2013

BLACK HAWK BERRY, CARRIE ARNP - IAM WATERLOO 50703 BLACK HAWK Female Accepted FC 9/10/2013

BLACK HAWK BONTHIUS, HEIDI - IAM WATERLOO 50702 BLACK HAWK Female Accepted FC 9/13/2013

BLACK HAWK BONTHIUS, HEIDI - IAM WATERLOO 50702 BLACK HAWK Female Accepted FC 9/19/2013

BLACK HAWK BONTHIUS, HEIDI - IAM WATERLOO 50702 BLACK HAWK Female Accepted FC 9/23/2013

BLACK HAWK BONTHIUS, HEIDI - IAM WATERLOO 50702 BLACK HAWK Male Accepted FC 9/27/2013

BLACK HAWK BREITKREUZ, DAVID DR - IAM WATERLOO 50702 BLACK HAWK Female Accepted FC 9/9/2013

BLACK HAWK COVENANT CLINIC WATERLOO 50702 BLACK HAWK Not Asked Declined FC 9/19/2013

BLACK HAWK CUE, RHONDA - IAM WATERLOO 50702 BLACK HAWK Female Accepted FC 9/27/2013

BLACK HAWK DUCLOS, SHARON - IAM WATERLOO 50703 BLACK HAWK Female Accepted FC 9/3/2013

BLACK HAWK ENGHOLM, ISSAC DR - IAM WATERLOO 50702 BLACK HAWK Male Accepted FC 9/27/2013

BLACK HAWK ENGHOLM, ISSAC DR - IAM WATERLOO 50702 BLACK HAWK Not Asked Active 9/24/2013

BLACK HAWK FOENS, CASSANDRA DR - IAM WATERLOO 50702 BLACK HAWK Male Active 9/27/2013

BLACK HAWK HENDERSON, VICKI - IAM WATERLOO 50703 BLACK HAWK Male Accepted FC 9/19/2013

BLACK HAWK HENDERSON, VICKI - IAM WATERLOO 50703 BLACK HAWK Female Accepted FC 9/17/2013

BLACK HAWK HENDERSON, VICKI - IAM WATERLOO 50703 BLACK HAWK Female Accepted FC 9/4/2013

BLACK HAWK HENDERSON, VICKI - IAM WATERLOO 50703 BLACK HAWK Female Accepted FC 9/6/2013

BLACK HAWK KEENAN, MARY - IAM EVANSDALE 50707 BLACK HAWK Female Accepted FC 9/9/2013

BLACK HAWK LIES, MARILYN MD - IAM EVANSDALE 50707 BLACK HAWK Female Accepted FC 9/27/2013

BLACK HAWK LIES, MARILYN MD - IAM EVANSDALE 50707 BLACK HAWK Not Asked Active 9/27/2013

BLACK HAWK MENKEN, MEAGAN ARNP - IAM WATERLOO 50702 BLACK HAWK Not Asked Unreachable 9/6/2013

BLACK HAWK MONROE, ASHLEY ARNP - IAM WATERLOO 50701 BLACK HAWK Female Accepted FC 9/4/2013

BLACK HAWK MONROE, ASHLEY ARNP - IAM WATERLOO 50701 BREMER Male Accepted FC 9/25/2013

BLACK HAWK MORRIS, MEGHAN DR WATERLOO 50702 BLACK HAWK Male Accepted FC 9/17/2013

BLACK HAWK MUSTAFIC, LYDIA - IAM WATERLOO 50702 BLACK HAWK Not Asked Active 9/27/2013

BLACK HAWK OTTMAN, MELISSA ARNP - IAM WATERLOO 50703 BLACK HAWK Female Accepted FC 9/24/2013

BLACK HAWK PETERSON, JAMES - IAM CEDAR FALLS 50613 BLACK HAWK Male Accepted FC 9/24/2013

BLACK HAWK RIADZAKY, ALFONSE DR - IAM WATERLOO 50703 BUCHANAN Male Unreachable 9/10/2013

BLACK HAWK SANDELL, JULIE - IAM CEDAR FALLS 50613 BLACK HAWK Male Unreachable 9/6/2013

BLACK HAWK SANKEY, BRIAN DR - IAM WATERLOO 50702 BLACK HAWK Female Accepted FC 9/24/2013

Page 2: Clinic County Clinic Name Clinic City Clinic Zip ... 2013 F… · BREMER EDEKER, JENNIFER ARNP - IAM DENVER 50622 BREMER Not Asked Unreachable 9/6/2013 BREMER WAVERLY HEALTH CENTER

Clinic County Clinic Name Clinic City Clinic Zip Participant

County

Participant

Gender

Enrollment Status Fax Received Date

BLACK HAWK SHAIKH, RAHIL DR - IAM WATERLOO 50702 BLACK HAWK Male Accepted FC 9/18/2013

BLACK HAWK SHREESHA, UDAYA DR - IAM WATERLOO 50702 BLACK HAWK Male Accepted FC 9/3/2013

BLACK HAWK SPRINGER, CARLA - IAM WATERLOO 50701 Not Asked Unreachable 9/10/2013

BLACK HAWK STANDING, LARRY - IAM CEDAR FALLS 50613 BLACK HAWK Not Asked Active 9/27/2013

BLACK HAWK VISOKEY, DAVID DR - IAM WATERLOO 50702 BLACK HAWK Female Accepted FC 9/3/2013

BOONE BOONE COUNTY HOSPITAL DIABETES CARE BOONE 50036 BOONE Female Accepted FC 9/10/2013

BOONE BOONE COUNTY HOSPITAL DIABETES CARE BOONE 50036 BOONE Female Accepted FC 9/16/2013

BREMER EDEKER, JENNIFER ARNP - IAM DENVER 50622 BREMER Not Asked Unreachable 9/6/2013

BREMER WAVERLY HEALTH CENTER - WOMEN'S

CLINIC

WAVERLY 50677 BREMER Female Accepted FC 9/10/2013

BUCHANAN FELDKAMP, MARK DR JESUP 50648 BUCHANAN Female Accepted FC 9/13/2013

BUENA VISTA SHEPHERD, LISA - IAM STORM LAKE 50588 BUENA VISTA Female Accepted FC 9/24/2013

BUTLER BOEVERS, JESSICA DR - IAM SHELL ROCK 50670 BREMER Female Accepted FC 9/18/2013

BUTLER BOEVERS, JESSICA DR - IAM SHELL ROCK 50670 BREMER Female Unreachable 9/10/2013

BUTLER DUCLOS, SHARON - IAM CLARKSVILLE 50619 BUTLER Male Active 9/27/2013

BUTLER NELSON, JERRY - IAM CLARKSVILLE 50619 BUTLER Male Accepted FC 9/19/2013

BUTLER NELSON, JERRY - IAM CLARKSVILLE 50619 FLOYD Female Accepted FC 9/6/2013

Calhoun DUNCAN, DEREK - IAM LAKE CITY CALHOUN Male Accepted FC 9/6/2013

CARROLL VOGL, CARA - IAM CARROLL 51401 CARROLL Female Accepted FC 9/9/2013

CARROLL VOGL, CARA - IAM CARROLL 51401 CARROLL Male Accepted FC 9/6/2013

CARROLL VOGL, CARA - IAM CARROLL 51401 CARROLL Male Declined FC 9/4/2013

Cass BROWN II, JAMES DR - IAM ATLANTIC SHELBY Female Accepted FC 9/3/2013

CASS ATLANTIC MEDICAL CENTER ATLANTIC 50022 CASS Not Asked Unreachable 9/13/2013

CASS BEAN, TODD MD - IAM ATLANTIC 50022 MONTGOMERY Male Accepted FC 9/23/2013

CASS CARE FOR YOURSELF ATLANTIC 50022 CASS Not Asked Unreachable 9/17/2013

CASS CARE FOR YOURSELF ATLANTIC 50022 POTTAWATTAMI

E

Not Asked Unreachable 9/9/2013

CASS FULLER, MARY - IAM ATLANTIC 50022 CASS Female Accepted FC 9/13/2013

CASS FULLER, MARY - IAM ATLANTIC 50022 CASS Female Accepted FC 9/24/2013

CASS FULLER, MARY - IAM ATLANTIC 50022 CASS Male Accepted FC 9/25/2013

CERRO GORDO DEBRAH, JOANNE - IAM MASON CITY 50401 CERRO GORDO Male Accepted FC 9/4/2013

CERRO GORDO GARCIA, ANGEL DR - IAM MASON CITY 50401 CERRO GORDO Female Accepted FC 9/10/2013

CERRO GORDO MERCY WOMEN'S HEALTH CENTER MASON CITY 50401 CERRO GORDO Female Accepted FC 9/24/2013

CERRO GORDO PRPS MASON CITY 50401 WORTH Female Accepted FC 9/17/2013

CERRO GORDO TIMPE, DONELL MD - IAM MASON CITY 50428 CERRO GORDO Female Accepted FC 9/3/2013

CLARKE GILBERT, SUSAN ARNP - IAM OSCEOLA 50213 CLARKE Male Accepted FC 9/25/2013

CLAY WITT, TRAVIS MD - IAM SPENCER 51301 CLAY Female Accepted FC 9/19/2013

CLINTON BARAKAT, SUHEIL - IAM CLINTON CLINTON Female Accepted FC 9/19/2013

CLINTON HOFF, STEPHANE DR - IAM CLINTON CLINTON Female Unreachable 9/10/2013

CLINTON FOWLER, STEVEN DE WITT 52742 CLINTON Not Asked Declined FC 9/20/2013

CLINTON FOWLER, STEVEN - IAM DE WITT 52742 CLINTON Male Accepted FC 9/20/2013

CLINTON MARILIM, MEL - IAM CLINTON 52732 CLINTON Male Accepted FC 9/23/2013

CLINTON PLA, RAMON - IAM CLINTON 52732 CLINTON Not Asked Unreachable 9/12/2013

CLINTON ROBINSON, RANDY - IAM CLINTON 52732 CLINTON Male Accepted FC 9/10/2013

CLINTON SMITH, DENICE DR - IAM CLINTON 52732 CLINTON Female Accepted FC 9/11/2013

CLINTON SMITH, DENICE DR - IAM CLINTON 52732 CLINTON Female Accepted FC 9/4/2013

Page 3: Clinic County Clinic Name Clinic City Clinic Zip ... 2013 F… · BREMER EDEKER, JENNIFER ARNP - IAM DENVER 50622 BREMER Not Asked Unreachable 9/6/2013 BREMER WAVERLY HEALTH CENTER

Clinic County Clinic Name Clinic City Clinic Zip Participant

County

Participant

Gender

Enrollment Status Fax Received Date

CLINTON SMITH, DENICE DR - IAM CLINTON 52732 CLINTON Male Accepted FC 9/16/2013

CRAWFORD MASON, RM - IAM DENISON CRAWFORD Female Accepted FC 9/27/2013

CRAWFORD CRABB, DW MD - IAM DENISON 51442 CRAWFORD Male Accepted FC 9/13/2013

CRAWFORD CRABB, DW MD - IAM DENISON 51442 CRAWFORD Male Unreachable 9/11/2013

CRAWFORD CRAWFORD COUNTY PUBLIC HEALTH DENISON 51442 CRAWFORD Not Asked Unreachable 9/9/2013

CRAWFORD NEISIUS, ROCHELLE - IAM PRAIRIE DU CHIEN 53821 CLAYTON Female Accepted FC 9/16/2013

DALLAS KLISE, KURT - IAM PERRY 50220 DALLAS Female Accepted FC 9/20/2013

DECATUR MIAL, SCOTT MD - IAM LEON 50144 DECATUR Male Accepted FC 9/13/2013

DECATUR RICHARD, LARRY MD - IAM LEON 50144 DECATUR Female Accepted FC 9/20/2013

DECATUR RICHARD, LARRY MD - IAM LEON 50144 DECATUR Female Unreachable 9/12/2013

DECATUR RICHARD, LARRY MD - IAM LEON 50144 DECATUR Female Unreachable 9/3/2013

DELAWARE REGIONAL FAMILY HEALTH HOPKINTON 52237 DELAWARE Not Asked Unreachable 9/3/2013

DELAWARE REGIONAL FAMILY HEALTH HOPKINTON 52237 DELAWARE Not Asked Unreachable 9/11/2013

DELAWARE REGIONAL FAMILY HEALTH HOPKINTON 52237 DELAWARE Not Asked Unreachable 9/11/2013

DES MOINES ARNOLD, JONATHAN - IAM WEST

BURLINGTON

52655 MUSCATINE Female Accepted FC 9/13/2013

DES MOINES BELL, TRACY DR - IAM WEST

BURLINGTON

52655 DES MOINES Female Accepted FC 9/18/2013

DES MOINES LAUER, GEORGIA PAC - IAM BURLINGTON 52601 DES MOINES Male Accepted FC 9/23/2013

DICKINSON GOERSS, JEFFREY MD - IAM SPIRIT LAKE 51360 DICKINSON Male Accepted FC 9/4/2013

DICKINSON ROENFANZ, KELLI - IAM SPIRIT LAKE 51360 DICKINSON Male Accepted FC 9/9/2013

DOUGLAS JENSEN CLINIC PC OMAHA 68124 POTTAWATTAMI

E

Female Accepted FC 9/10/2013

DUBUQUE BRIMEYER, BETTY - IAM DUBUQUE 52001 DUBUQUE Male Accepted FC 9/9/2013

DUBUQUE BRIMEYER, BETTY - IAM DUBUQUE 52001 FAYETTE Male Accepted FC 9/19/2013

DUBUQUE BRIMEYER, BETTY - IAM DUBUQUE 52001 CLAYTON Not Asked Unreachable 9/17/2013

DUBUQUE FINLEY PAIN CLINIC DUBUQUE 52003 DUBUQUE Male Accepted FC 9/11/2013

DUBUQUE LABEAU, DEBORAH - IAM DUBUQUE 52001 DUBUQUE Not Asked Unreachable 9/3/2013

DUBUQUE POWERS, JILL DO - IAM DUBUQUE 52001 DUBUQUE Female Accepted FC 9/9/2013

DUBUQUE SALAS, HILARY MD - IAM DUBUQUE 52001 DUBUQUE Female Accepted FC 9/20/2013

DUBUQUE SALAS, HILARY MD - IAM DUBUQUE 52001 DUBUQUE Female Unreachable 9/13/2013

DUBUQUE SINSKY, THOMAS MD - IAM DUBUQUE 52001 DUBUQUE Male Accepted FC 9/24/2013

DUBUQUE UNITY POINT CLINIC CASCADE CASCADE 52033 DUBUQUE Not Asked Declined FC 9/10/2013

DUBUQUE WOLBERS, REGAN MD - IAM DUBUQUE 52001 DUBUQUE Female Accepted FC 9/10/2013

Dubuque KRAMER, LISA DR - IAM DUBUQUE Female Accepted FC 9/3/2013

FAYETTE BOCKENSTEDT, KRIS - IAM ARLINGTON 50606 FAYETTE Not Asked Unreachable 9/19/2013

FAYETTE CONNELLY, DARCY PAC - IAM WEST UNION 52175 FAYETTE Female Accepted FC 9/10/2013

FAYETTE DALIL, NASREDIN DR - IAM OELWEIN 50662 FAYETTE Female Accepted FC 9/19/2013

FAYETTE DALIL, NASREDIN DR - IAM OELWEIN 50662 BUCHANAN Female Accepted FC 9/19/2013

FRANKLIN DENNIS, DAVID DO - IAM HAMPTON 50441 FRANKLIN Female Accepted FC 9/16/2013

FRANKLIN MORETZ, JOY - IAM SHEFFIELD 50475 FRANKLIN Female Accepted FC 9/16/2013

FRANKLIN MORETZ, JOY PAC - IAM SHEFFIELD 50475 FRANKLIN Female Accepted FC 9/11/2013

GREENE MCFARLAND CLINIC JEFFERSON 50129 GREENE Female Accepted FC 9/20/2013

GRUNDY DIAB - GRUNDY COUNTY GRUNDY CENTER 50638 GRUNDY Not Asked Unreachable 9/17/2013

HANCOCK BOEDEKER, JOHN DR - IAM GARNER 50438 HANCOCK Female Accepted FC 9/17/2013

HANCOCK BRITT MEDICAL CLINIC BRITT 50423 Not Asked Declined FC 9/27/2013

HANCOCK HANCOCK COUNTY COMMUNITY HEALTH GARNER 50438 HANCOCK Not Asked Unreachable 9/10/2013

Hardin WILWERT, JEFFREY DR - IAM ELDORA HARDIN Male Accepted FC 9/20/2013

Page 4: Clinic County Clinic Name Clinic City Clinic Zip ... 2013 F… · BREMER EDEKER, JENNIFER ARNP - IAM DENVER 50622 BREMER Not Asked Unreachable 9/6/2013 BREMER WAVERLY HEALTH CENTER

Clinic County Clinic Name Clinic City Clinic Zip Participant

County

Participant

Gender

Enrollment Status Fax Received Date

Hardin WILWERT, JEFFREY DR - IAM ELDORA HARDIN Male Unreachable 9/13/2013

HARRISON LOB, MARY MD - IAM LOGAN 51546 HARRISON Male Accepted FC 9/19/2013

HENRY LEDGER, SARAH - IAM MOUNT PLEASANT 52641 HENRY Not Asked Unreachable 9/9/2013

HENRY WAGNER, JULIE DO - IAM MOUNT PLEASANT 52641 HENRY Female Accepted FC 9/11/2013

HOWARD MAHER, J DAVID - IAM CRESCO 52136 HOWARD Female Accepted FC 9/19/2013

HUMBOLDT BENJAMIN, KERI - IAM HUMBOLDT 50548 HUMBOLDT Not Asked Unreachable 9/9/2013

HUMBOLDT RICHMOND, SHAWN DR - IAM RENWICK 50577 MAHASKA Male Accepted FC 9/12/2013

JACKSON LIVESAY, JODY ARNP - IAM MAQUOKETA 52060 JACKSON Female Accepted FC 9/10/2013

JACKSON PETERSEN, ERIC - IAM MAQUOKETA 52060 JACKSON Female Accepted FC 9/6/2013

JACKSON PETERSEN, ERIC - IAM MAQUOKETA 52060 JACKSON Male Accepted FC 9/17/2013

JACKSON STEINES, TRICIA ARNP - IAM MAQUOKETA 52060 JACKSON Male Accepted FC 9/24/2013

JASPER ALEXANDER, ZACHARY - IAM NEWTON 50208 MARSHALL Male Accepted FC 9/3/2013

JASPER JOLIVETTE, DUANE - IAM NEWTON 50208 POWESHIEK Female Accepted FC 9/11/2013

JASPER JOLIVETTE, DUANE - IAM NEWTON 50208 POWESHIEK Male Accepted FC 9/11/2013

JASPER KETHIREDDY, MALINI - IAM NEWTON 50208 JASPER Female Accepted FC 9/16/2013

JEFFERSON ANDERSON, DEREK DR - IAM FAIRFIELD 52556 JEFFERSON Male Accepted FC 9/19/2013

JEFFERSON HANSHAW, JONI ARNP - IAM FAIRFIELD 52556 JEFFERSON Not Asked Unreachable 9/20/2013

JEFFERSON HILL, DONAL DO - IAM FAIRFIELD 52556 JEFFERSON Not Asked Unreachable 9/16/2013

JEFFERSON THE FAIRFIELD CLINIC PC FAIRFIELD 52556 HENRY Male Accepted FC 9/24/2013

JOHNSON BIEBER, DALE MD - IAM IOWA CITY LINN Male Unreachable 9/10/2013

JOHNSON EBERLY, SCOTT DR - IAM IOWA CITY JOHNSON Male Accepted FC 9/12/2013

JOHNSON GEBSKA, MILENA - IAM CORALVILLE Not Asked Unreachable 9/16/2013

JOHNSON KEY, RANDI ARNP - IAM MUSCATINE Not Asked Unreachable 9/18/2013

JOHNSON SHEPARD, JAMI DR - IAM CORALVILLE CEDAR Not Asked Active 9/27/2013

JOHNSON ABERNATHY, MABRA G - IAM IOWA CITY 52242 LINN Not Asked Active 9/23/2013

JOHNSON ABOUALAIWA, MAHMOUD - IAM IOWA CITY 52242 DUBUQUE Male Accepted FC 9/19/2013

JOHNSON BAKER, KIM DR - IAM IOWA CITY 52242 OBRIEN Male Accepted FC 9/16/2013

JOHNSON BANU, HUSSAIN MD - IAM IOWA CITY 52242 LINN Female Accepted FC 9/16/2013

JOHNSON BANU, HUSSAIN MD - IAM IOWA CITY 52242 SCOTT Female Accepted FC 9/16/2013

JOHNSON BANU, HUSSAIN MD - IAM IOWA CITY 52242 DES MOINES Female Accepted FC 9/24/2013

JOHNSON BANU, HUSSAIN MD - IAM IOWA CITY 52242 JOHNSON Female Accepted FC 9/27/2013

JOHNSON BANU, HUSSAIN MD - IAM IOWA CITY 52242 CLINTON Female Accepted FC 9/25/2013

JOHNSON BANU, HUSSAIN MD - IAM IOWA CITY 52242 LEE Female Accepted FC 9/10/2013

JOHNSON BANU, HUSSAIN MD - IAM IOWA CITY 52242 MUSCATINE Female Accepted FC 9/10/2013

JOHNSON BANU, HUSSAIN MD - IAM IOWA CITY 52242 WAPELLO Female Accepted FC 9/6/2013

JOHNSON BANU, HUSSAIN MD - IAM IOWA CITY 52242 LINN Female Accepted FC 9/6/2013

JOHNSON BANU, HUSSAIN MD - IAM IOWA CITY 52242 BENTON Male Declined FC 9/23/2013

JOHNSON BANU, HUSSAIN MD - IAM IOWA CITY 52242 JOHNSON Female Unreachable 9/6/2013

JOHNSON BUCHKINA, JULIA - IAM IOWA CITY 52242 JOHNSON Female Accepted FC 9/19/2013

JOHNSON BURSTAIN, TODD - IAM CORALVILLE 52241 SCOTT Female Accepted FC 9/23/2013

JOHNSON BUTLER, NICHOLAS - IAM IOWA CITY 52242 JOHNSON Male Accepted FC 9/23/2013

JOHNSON CARABELLO, JUAN - IAM IOWA CITY 52242 LOUISA Male Accepted FC 9/23/2013

JOHNSON CLAMON, GERALD DR - IAM IOWA CITY 52242 DUBUQUE Male Accepted FC 9/11/2013

JOHNSON CONNETT, MEGHAN - IAM IOWA CITY 52242 LINN Female Unreachable 9/24/2013

JOHNSON DAVIS-DEGEUS, MEGAN IOWA CITY 52242 SCOTT Male Accepted FC 9/3/2013

Page 5: Clinic County Clinic Name Clinic City Clinic Zip ... 2013 F… · BREMER EDEKER, JENNIFER ARNP - IAM DENVER 50622 BREMER Not Asked Unreachable 9/6/2013 BREMER WAVERLY HEALTH CENTER

Clinic County Clinic Name Clinic City Clinic Zip Participant

County

Participant

Gender

Enrollment Status Fax Received Date

JOHNSON DAVIS-DEGEUS, MEGAN - IAM IOWA CITY 52242 DUBUQUE Female Accepted FC 9/23/2013

JOHNSON DEYOUNG, DUSTIN MD IOWA CITY 52242 WARREN Not Asked Unreachable 9/9/2013

JOHNSON DIRKSEN, RACHAEL - IAM CORALVILLE 52241 JOHNSON Female Accepted FC 9/3/2013

JOHNSON DONOVAN, JENNIFER - IAM IOWA CITY 52242 LINN Not Asked Declined FC 9/5/2013

JOHNSON DUNKELBERG, JEFF MD - IAM IOWA CITY 52242 SCOTT Not Asked Active 9/24/2013

JOHNSON GEBSKA, MILENA DR - IAM IOWA CITY 52242 BLACK HAWK Male Accepted FC 9/13/2013

JOHNSON GOMENDOZA, MICHAEL MD - IAM CORALVILLE 52241 MUSCATINE Female Accepted FC 9/10/2013

JOHNSON HEGEMAN, ROBERT - IAM CORALVILLE 52241 JONES Not Asked Unreachable 9/11/2013

JOHNSON JACOBITZ-KIZZIER, SARAH - IAM IOWA CITY 52242 JOHNSON Not Asked Unreachable 9/24/2013

JOHNSON JOY, PARIJAT - IAM IOWA CITY 52242 CLINTON Not Asked Unreachable 9/23/2013

JOHNSON KATZ, DAVID MD - IAM IOWA CITY 52242 LINN Female Accepted FC 9/28/2013

JOHNSON LANTERNIER, MATTHEW - IAM IOWA CITY 52240 JOHNSON Female Accepted FC 9/9/2013

JOHNSON MARCUSSEN, BRITT - IAM IOWA CITY 52246 JOHNSON Female Accepted FC 9/25/2013

JOHNSON MILLER, DELYN - IAM IOWA CITY 52242 JOHNSON Male Accepted FC 9/24/2013

JOHNSON PRASIDTHRATHSINT, KUNATUM - IAM IOWA CITY 52242 STORY Male Accepted FC 9/11/2013

JOHNSON PRATER, JANE ARNP - IAM IOWA CITY 52242 LINN Female Accepted FC 9/4/2013

JOHNSON PRATER, NICOLA - IAM IOWA CITY 52242 LEE Female Accepted FC 9/4/2013

JOHNSON SHAIK, SHALINA - IAM IOWA CITY 52242 LINN Female Accepted FC 9/24/2013

JOHNSON SHAIK, SHALINA - IAM IOWA CITY 52242 SCOTT Female Accepted FC 9/24/2013

JOHNSON SHAIK, SHALINA - IAM IOWA CITY 52242 SCOTT Female Accepted FC 9/27/2013

JOHNSON SHAIK, SHALINA - IAM IOWA CITY 52242 LINN Female Unreachable 9/16/2013

JOHNSON SHAIK, SHALINA - IAM IOWA CITY 52242 CLINTON Not Asked Unreachable 9/3/2013

JOHNSON U OF I HEALTHCARE - MEDICINE SPECIALTY

CLINIC

IOWA CITY 52242 STORY Male Declined FC 9/4/2013

JOHNSON UNIVERSITY OF IOWA IOWA CITY 52242 LEE Not Asked Unreachable 9/16/2013

JOHNSON WIBLIN, TODD MD - IAM CORALVILLE 52241 JOHNSON Not Asked Accepted FC 9/9/2013

Johnson GASS, JASON - IAM POLK Not Asked Unreachable 9/6/2013

KEOKUK BAKER, ROBERT PAC - IAM SIGOURNEY 52591 KEOKUK Female Accepted FC 9/9/2013

KEOKUK BAKER, ROBERT PAC - IAM SIGOURNEY 52591 KEOKUK Female Accepted FC 9/4/2013

KEOKUK BAKER, ROBERT PAC - IAM SIGOURNEY 52591 KEOKUK Female Active 9/24/2013

KEOKUK UI FAMILY CARE SIGNORNEY SIGOURNEY 52591 POWESHIEK Male Accepted FC 9/10/2013

KEOKUK UI FAMILY CARE SIGNORNEY SIGOURNEY 52591 POWESHIEK Female Accepted FC 9/10/2013

KOSSUTH ETHERINGTON, KIMBERLY PAC - IAM ALGONA 50511 KOSSUTH Female Accepted FC 9/19/2013

LEE FORT MADISON PHYSICIANS & SURGEONS -

FAMILY PRACTICE

FORT MADISON 52627 LEE Not Asked Active 9/27/2013

LEE NEWTON, CHASE DO - IAM FORT MADISON 52627 LEE Female Accepted FC 9/25/2013

LEE NEWTON, CHASE DO - IAM FORT MADISON 52627 LEE Not Asked Unreachable 9/16/2013

LEE SCHULTE, WILLIAM KEOKUK 52632 LEE Female Accepted FC 9/20/2013

LINN BECK, JENNIFER MD - IAM HIAWATHA LINN Female Accepted FC 9/6/2013

LINN BENTLEY, LAURA MD - IAM CEDAR RAPIDS 52401 LINN Female Accepted FC 9/27/2013

LINN BOWMAN WOODS FAMILY MEDICINE CEDAR RAPIDS 52402 LINN Female Accepted FC 9/3/2013

LINN BROWN-BENN, CARRIE ARNP - IAM MARION 52302 LINN Not Asked Unreachable 9/16/2013

LINN BUTLER, TODD - IAM HIAWATHA 52233 LINN Male Accepted FC 9/4/2013

LINN CEARRAS, MARTIN - IAM CEDAR RAPIDS 52401 LINN Female Accepted FC 9/9/2013

LINN COWDEN, J DAVID DR - IAM CEDAR RAPIDS 52402 JONES Female Unreachable 9/20/2013

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Clinic County Clinic Name Clinic City Clinic Zip Participant

County

Participant

Gender

Enrollment Status Fax Received Date

LINN DAVENPORT, CRAIG DR - IAM CEDAR RAPIDS 52403 LINN Not Asked Unreachable 9/4/2013

LINN DODD, KHUSHMAN MD - IAM CEDAR RAPIDS 52403 LINN Female Accepted FC 9/9/2013

LINN ELLIS, JASON - IAM CEDAR RAPIDS 52403 Not Asked Unreachable 9/9/2013

LINN GOLDBLATT, FRED - IAM MARION 52302 LINN Female Accepted FC 9/11/2013

LINN GOLDBLATT, FRED - IAM MARION 52302 LINN Male Accepted FC 9/12/2013

LINN INTERNISTS ASSOC OF IA CEDAR RAPIDS 52401 LINN Female Accepted FC 9/13/2013

LINN INTERNISTS ASSOC OF IA CEDAR RAPIDS 52401 LINN Not Asked Active 9/25/2013

LINN INTERNISTS ASSOC OF IA CEDAR RAPIDS 52401 LINN Not Asked Declined FC 9/13/2013

LINN INTERNISTS ASSOC OF IA CEDAR RAPIDS 52401 LINN Not Asked Unreachable 9/13/2013

LINN INTERNISTS ASSOC OF IA CEDAR RAPIDS 52401 LINN Not Asked Unreachable 9/6/2013

LINN KAVANAUGH, KATIE ARNP - IAM CEDAR RAPIDS 52402 LINN Female Accepted FC 9/23/2013

LINN KAVANAUGH, KATIE ARNP - IAM CEDAR RAPIDS 52402 LINN Female Accepted FC 9/23/2013

LINN MEEKER, MONICA DR - IAM MOUNT VERNON 52314 LINN Female Accepted FC 9/19/2013

LINN MERCY CARE VERNON VILLAGE CEDAR RAPIDS 52403 CLAYTON Female Accepted FC 9/13/2013

LINN METROPOLITAN FAMILY MEDICINE &

CHIROPRACTIC

HIAWATHA 52233 CEDAR Female Accepted FC 9/12/2013

LINN MILLER, BEN - IAM CEDAR RAPIDS 52403 LINN Female Accepted FC 9/18/2013

LINN MILLER, BEN - IAM CEDAR RAPIDS 52403 LINN Female Unreachable 9/13/2013

LINN PFAB, KARI - IAM CEDAR RAPIDS 52403 LINN Not Asked Unreachable 9/10/2013

LINN PORT, ABBIE PAC HIAWATHA 52233 LINN Not Asked Unreachable 9/19/2013

LINN RAMSEY, MERRILEE ARNP - IAM CEDAR RAPIDS 52403 LINN Female Accepted FC 9/20/2013

LINN RAY, BRIAN DO - IAM HIAWATHA 52233 LINN Female Accepted FC 9/6/2013

LINN ROBINSON, STEPHANIE ARNP - IAM HIAWATHA 52233 BENTON Female Accepted FC 9/19/2013

LINN ROBINSON, STEPHANIE ARNP - IAM HIAWATHA 52233 BENTON Female Unreachable 9/9/2013

LINN SHEFF, DAVID - IAM CEDAR RAPIDS 52403 LINN Female Accepted FC 9/25/2013

LINN SLADEK, STEPHEN - IAM CEDAR RAPIDS 52402 LINN Female Accepted FC 9/16/2013

LINN SLADEK, STEPHEN - IAM CEDAR RAPIDS 52402 LINN Female Accepted FC 9/9/2013

LINN SOENEN, ANN DO - IAM CEDAR RAPIDS 52403 LINN Female Accepted FC 9/10/2013

LINN SOENEN, ANN DO - IAM CEDAR RAPIDS 52403 LINN Female Accepted FC 9/27/2013

LINN SOUKIEH, HOUSAM - IAM CEDAR RAPIDS 52401 LINN Male Accepted FC 9/10/2013

LINN ST LUKE'S HOSPITAL CEDAR RAPIDS 52402 LINN Female Declined FC 9/19/2013

LINN ST LUKE'S HOSPITAL CEDAR RAPIDS 52402 LINN Not Asked Unreachable 9/16/2013

LINN ST LUKE'S HOSPITAL CEDAR RAPIDS 52402 LINN Male Unreachable 9/10/2013

LINN STEWART, TERESA PAC - IAM CEDAR RAPIDS 52402 LINN Female Accepted FC 9/6/2013

LINN STEWART, TERESA PAC - IAM CEDAR RAPIDS 52402 LINN Male Accepted FC 9/3/2013

LINN STEWART, TERESA PAC - IAM CEDAR RAPIDS 52402 LINN Female Accepted FC 9/18/2013

LINN STEWART, TERESA PAC - IAM CEDAR RAPIDS 52402 LINN Male Accepted FC 9/23/2013

LINN WILKINSON, MARC MD - IAM CEDAR RAPIDS 52401 LINN Female Accepted FC 9/5/2013

Linn ROOF, JOHN - IAM LINN Female Active 9/25/2013

Llinn RAJU, NYGI MD - IAM CEDAR RAPIDS LINN Female Accepted FC 9/13/2013

LUCAS KRUTSINGER, ALLISON PAC - IAM CHARITON 50049 LUCAS Not Asked Unreachable 9/9/2013

LYON SANFORD CLINIC ROCK RAPIDS ROCK RAPIDS 51246 LYON Not Asked Declined FC 9/17/2013

MADISON DEREGNIER, KEVIN - IAM WINTERSET 50273 CLARKE Not Asked Declined FC 9/9/2013

MAHASKA MINEART, STEPHEN MD - IAM OSKALOOSA MAHASKA Male Accepted FC 9/4/2013

MAHASKA HENDERSON, MARY KAY - IAM OSKALOOSA 52577 WAPELLO Female Unreachable 9/9/2013

Page 7: Clinic County Clinic Name Clinic City Clinic Zip ... 2013 F… · BREMER EDEKER, JENNIFER ARNP - IAM DENVER 50622 BREMER Not Asked Unreachable 9/6/2013 BREMER WAVERLY HEALTH CENTER

Clinic County Clinic Name Clinic City Clinic Zip Participant

County

Participant

Gender

Enrollment Status Fax Received Date

MARION JAYAVEERAPANDIAN, BHAMA DR - IAM KNOXVILLE 50138 MARION Female Unreachable 9/19/2013

MARION LANPHIER, ALLISON PAC - IAM KNOXVILLE 50138 JASPER Female Accepted FC 9/6/2013

MARION ROWLEY, DAN DR - IAM KNOXVILLE 50138 MARION Male Accepted FC 9/18/2013

MARION WIC - MARION COUNTY PUBLIC HEALTH

DEPT

KNOXVILLE 50138 MARION Female Accepted FC 9/17/2013

MARSHALL DEMMEL, JAMES - IAM MARSHALLTOWN 50158 MARSHALL Female Accepted FC 9/18/2013

MARSHALL GEORGE, AMANDA - IAM STATE CENTER 50247 MARSHALL Female Accepted FC 9/24/2013

MARSHALL LEONARD, KATHY ARNP - IAM MARSHALLTOWN 50158 MARSHALL Female Accepted FC 9/16/2013

MARSHALL O'HANLON, ANDREA PAC - IAM MARSHALLTOWN 50158 CERRO GORDO Female Accepted FC 9/16/2013

MARSHALL O'HANLON, ANDREA PAC - IAM MARSHALLTOWN 50158 CERRO GORDO Male Accepted FC 9/24/2013

MARSHALL O'HANLON, ANDREA PAC - IAM MARSHALLTOWN 50158 CERRO GORDO Female Accepted FC 9/9/2013

MARSHALL O'HANLON, ANDREA PAC - IAM MARSHALLTOWN 50158 TAMA Not Asked Unreachable 9/17/2013

MARSHALL O'HANLON, ANDREA PAC - IAM MARSHALLTOWN 50158 MARSHALL Not Asked Unreachable 9/19/2013

MARSHALL OLSON, JOHN - IAM MARSHALLTOWN 50158 MARSHALL Female Accepted FC 9/13/2013

MARSHALL POLLPETER, JOSEPH - IAM MARSHALLTOWN 50158 MARSHALL Not Asked Unreachable 9/3/2013

MARSHALL SWINTON, TIM DR - IAM MARSHALLTOWN 50158 MARSHALL Female Accepted FC 9/4/2013

MILLS BAER, THOMAS - IAM GLENWOOD 51534 MILLS Female Accepted FC 9/6/2013

MINNEHAHA MCGREEVY CLINIC MAIN 7TH AVE SIOUX FALLS 57105 LYON Female Accepted FC 9/9/2013

Minnesota EBBERT, JON - IAM ROCHESTER WINNEBAGO Not Asked Unreachable 9/6/2013

MONONA GRODA-LEWIS, MARY - IAM ONAWA 51040 MONONA Female Accepted FC 9/27/2013

MONONA HCCMS FAMILY HEALTH SERVICES ONAWA 51040 MONONA Not Asked Declined FC 9/11/2013

MONONA HCCMS FAMILY HEALTH SERVICES ONAWA 51040 MONONA Not Asked Unreachable 9/11/2013

Monroe TROMBLEE, JOSHUA - IAM ALBIA MONROE Female Accepted FC 9/9/2013

MONROE CURIEL, ALEJANDRO - IAM ALBIA 52531 WAPELLO Female Accepted FC 9/13/2013

MONROE HAAS, GERALD DO - IAM ALBIA 52531 MONROE Female Accepted FC 9/6/2013

MUSCATINE BLOUSE, JAMES - IAM WILTON 52778 MUSCATINE Female Accepted FC 9/10/2013

MUSCATINE BLOUSE, JAMES - IAM WILTON 52778 MUSCATINE Not Asked Unreachable 9/10/2013

MUSCATINE COX, LINDSAY - IAM MUSCATINE 52761 MUSCATINE Female Unreachable 9/4/2013

MUSCATINE COX, LINDSAY - IAM MUSCATINE 52761 MUSCATINE Female Unreachable 9/17/2013

MUSCATINE GEORGE-PAULSEN, LESLIE - IAM MUSCATINE 52761 MUSCATINE Female Accepted FC 9/13/2013

MUSCATINE KIES, VALERIE PAC - IAM MUSCATINE 52761 MUSCATINE Female Accepted FC 9/4/2013

MUSCATINE KWIRANT, JAMES DR - IAM MUSCATINE 52761 Not Asked Active 9/27/2013

MUSCATINE MAHARRY, MICHAEL MD - IAM MUSCATINE 52761 MUSCATINE Female Accepted FC 9/16/2013

MUSCATINE MAHARRY, MICHAEL MD - IAM MUSCATINE 52761 MUSCATINE Female Accepted FC 9/20/2013

MUSCATINE MAHARRY, MICHAEL MD - IAM MUSCATINE 52761 MUSCATINE Male Accepted FC 9/3/2013

MUSCATINE PAULSRUD, STEVEN DR - IAM MUSCATINE 52761 MUSCATINE Male Accepted FC 9/6/2013

MUSCATINE PAULSRUD, STEVEN DR - IAM MUSCATINE 52761 MUSCATINE Female Accepted FC 9/9/2013

MUSCATINE PAULSRUD, STEVEN DR - IAM MUSCATINE 52761 MUSCATINE Male Accepted FC 9/10/2013

MUSCATINE PAULSRUD, STEVEN DR - IAM MUSCATINE 52761 MUSCATINE Male Accepted FC 9/11/2013

MUSCATINE PAULSRUD, STEVEN DR - IAM MUSCATINE 52761 MUSCATINE Female Accepted FC 9/24/2013

MUSCATINE PAULSRUD, STEVEN DR - IAM MUSCATINE 52761 MUSCATINE Not Asked Unreachable 9/13/2013

MUSCATINE SAGHA, HAMID - IAM MUSCATINE 52761 MUSCATINE Female Accepted FC 9/17/2013

MUSCATINE WISEMAN, KIMBERLY - IAM MUSCATINE 52761 MUSCATINE Female Accepted FC 9/19/2013

Not Available KHAN, MITCHELL - IAM JASPER Female Unreachable 9/9/2013

Not Available LEHL, DEANNA - IAM POLK Female Accepted FC 9/24/2013

Page 8: Clinic County Clinic Name Clinic City Clinic Zip ... 2013 F… · BREMER EDEKER, JENNIFER ARNP - IAM DENVER 50622 BREMER Not Asked Unreachable 9/6/2013 BREMER WAVERLY HEALTH CENTER

Clinic County Clinic Name Clinic City Clinic Zip Participant

County

Participant

Gender

Enrollment Status Fax Received Date

OBRIEN DUNN-JUNIUS, JOSEPHINE - IAM SHELDON 51201 OBRIEN Female Accepted FC 9/9/2013

OLMSTED HURT, RICHARD MD - IAM ROCHESTER 55905 CLARKE Female Accepted FC 9/17/2013

PAGE KING, SCOTT DR - IAM SHENANDOAH 51601 PAGE Not Asked Unreachable 9/3/2013

PAGE MARTINEZ, EFFIE - IAM CLARINDA 51632 PAGE Female Accepted FC 9/4/2013

PAGE PEDERSON, RONALD - IAM CLARINDA 51632 PAGE Female Accepted FC 9/19/2013

PAGE PEDERSON, RONALD - IAM CLARINDA 51632 PAGE Male Active 9/20/2013

PALO ALTO BANWART, PATRICIA DO - IAM EMMETSBURG 50536 PALO ALTO Not Asked Active 9/27/2013

PALO ALTO BOEVERS, JENNIFER - IAM EMMETSBURG 50536 POCAHONTAS Male Accepted FC 9/16/2013

PALO ALTO FAMILY PRACTICE CLINIC EMMETSBURG 50536 PALO ALTO Not Asked Unreachable 9/4/2013

PLYMOUTH KROHN, JEFF - IAM KINGSLEY 51028 WOODBURY Not Asked Unreachable 9/6/2013

Polk OLSON, LEATRICE DO - IAM Not Asked Unreachable 9/13/2013

polk SMITH, KURT - IAM DECATUR Not Asked Active 9/27/2013

Polk EVANS, RICHARD DO - IAM DES MOINES POLK Female Accepted FC 9/27/2013

Polk EVANS, RICHARD DO - IAM DES MOINES POLK Female Accepted FC 9/16/2013

Polk MAHER, WILLIAM - IAM DES MOINES POLK Not Asked Unreachable 9/19/2013

Polk ONSTUD, RACHEL - IAM POLK Female Active 9/27/2013

Polk REMER, DEANNE - IAM Not Asked Unreachable 9/24/2013

Polk WORTHINGTON, MACK - IAM POLK Female Unreachable 9/16/2013

POLK AICH, MUKTI MD - IAM DES MOINES 50316 POLK Female Accepted FC 9/9/2013

POLK AICH, MUKTI MD - IAM DES MOINES 50316 POLK Female Accepted FC 9/4/2013

POLK ARASON, EINAR DO - IAM ANKENY 50023 Not Asked Active 9/27/2013

POLK ASNER, YULIA DO - IAM DES MOINES 50314 POLK Female Accepted FC 9/27/2013

POLK ASNER, YULIA DO - IAM DES MOINES 50314 POLK Female Accepted FC 9/20/2013

POLK ASNER, YULIA DO - IAM DES MOINES 50314 POLK Female Accepted FC 9/4/2013

POLK ASNER, YULIA DO - IAM DES MOINES 50314 WARREN Male Accepted FC 9/5/2013

POLK BARAZANJI, MAJED - IAM WEST DES MOINES 50266 POLK Female Accepted FC 9/12/2013

POLK BARGER, MIKE PAC - IAM DES MOINES 50314 POLK Female Declined FC 9/11/2013

POLK BARGER, MIKE PAC - IAM DES MOINES 50314 POLK Not Asked Unreachable 9/11/2013

POLK BARGER, MIKE PAC - IAM DES MOINES 50314 POLK Not Asked Unreachable 9/18/2013

POLK BARNES, KRISTA - IAM DES MOINES 50314 POLK Female Accepted FC 9/9/2013

POLK BOLLIN, REBECCA - IAM DES MOINES 50314 POLK Female Accepted FC 9/3/2013

POLK BOLLIN, REBECCA - IAM DES MOINES 50314 WARREN Female Accepted FC 9/10/2013

POLK BROADLAWNS WOMEN'S HEALTH CENTER DES MOINES 50314 POLK Not Asked Declined FC 9/6/2013

POLK BROWN, JANAE ARNP - IAM DES MOINES 50312 POLK Not Asked Unreachable 9/17/2013

POLK CALLAHAN, ROBERT - IAM DES MOINES 50310 POLK Female Accepted FC 9/9/2013

POLK CASADY, SUSAN DO - IAM WINDSOR HEIGHTS 50324 POLK Female Unreachable 9/13/2013

POLK CIC ASSOC, PC CLIVE 50325 MARION Not Asked Unreachable 9/25/2013

POLK COX, PATRICIA ARNP - IAM ANKENY 50023 STORY Not Asked Unreachable 9/11/2013

POLK DAVIS, BEVERLY ARNP - IAM DES MOINES 50315 POLK Female Accepted FC 9/11/2013

POLK DYRHAUG, CHERYL - IAM DES MOINES 50317 POLK Female Accepted FC 9/9/2013

POLK ENGEBRETSEN, BERRY MD - IAM DES MOINES 50314 POLK Male Accepted FC 9/24/2013

POLK FLATT, JERROLD DR - IAM DES MOINES 50316 POLK Female Accepted FC 9/20/2013

POLK FURNESS, KEVIN - IAM DES MOINES 50314 POLK Female Accepted FC 9/24/2013

POLK GERRIETTS, JENNIFER DO - IAM DES MOINES 50315 POLK Female Accepted FC 9/27/2013

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Clinic County Clinic Name Clinic City Clinic Zip Participant

County

Participant

Gender

Enrollment Status Fax Received Date

POLK GERRIETTS, JENNIFER DO - IAM DES MOINES 50315 POLK Not Asked Unreachable 9/23/2013

POLK GILG, NICOLE DR - IAM DES MOINES 50314 POLK Female Accepted FC 9/24/2013

POLK GILG, NICOLE DR - IAM DES MOINES 50314 MONROE Male Accepted FC 9/24/2013

POLK GILG, NICOLE DR - IAM DES MOINES 50314 MONROE Female Accepted FC 9/24/2013

POLK GILG, NICOLE DR - IAM DES MOINES 50314 POLK Female Accepted FC 9/27/2013

POLK GILG, NICOLE DR - IAM DES MOINES 50314 DALLAS Male Accepted FC 9/6/2013

POLK GILG, NICOLE DR - IAM DES MOINES 50314 POLK Female Accepted FC 9/10/2013

POLK GILG, NICOLE DR - IAM DES MOINES 50314 POLK Male Accepted FC 9/10/2013

POLK GORE, MALHAR DR - IAM DES MOINES 50314 POLK Male Accepted FC 9/9/2013

POLK GORE, MALHAR DR - IAM DES MOINES 50314 POLK Male Accepted FC 9/9/2013

POLK GORE, MALHAR DR - IAM DES MOINES 50314 POLK Female Accepted FC 9/9/2013

POLK GORE, MALHAR DR - IAM DES MOINES 50314 POLK Female Accepted FC 9/23/2013

POLK GORE, MALHAR DR - IAM DES MOINES 50314 POLK Male Accepted FC 9/24/2013

POLK GORE, MALHAR DR - IAM DES MOINES 50314 POLK Not Asked Unreachable 9/16/2013

POLK HANSEN-PENMAN, WENDY - IAM DES MOINES 50314 POLK Male Accepted FC 9/16/2013

POLK HANSEN-PENMAN, WENDY - IAM DES MOINES 50314 POLK Male Accepted FC 9/19/2013

POLK HANSEN-PENMAN, WENDY - IAM DES MOINES 50314 POLK Male Accepted FC 9/25/2013

POLK HANSEN-PENMAN, WENDY - IAM DES MOINES 50314 POLK Male Accepted FC 9/12/2013

POLK HANSEN-PENMAN, WENDY - IAM DES MOINES 50314 POLK Female Accepted FC 9/13/2013

POLK HANSEN-PENMAN, WENDY - IAM DES MOINES 50314 POLK Not Asked Unreachable 9/19/2013

POLK HARVEY, HAYLEY DDS - IAM DES MOINES 50314 POLK Female Accepted FC 9/19/2013

POLK HARVEY, HAYLEY DDS - IAM DES MOINES 50314 POLK Male Accepted FC 9/19/2013

POLK HARVEY, HAYLEY DDS - IAM DES MOINES 50314 POLK Female Accepted FC 9/17/2013

POLK HARVEY, HAYLEY DDS - IAM DES MOINES 50314 POLK Female Accepted FC 9/10/2013

POLK HARVEY, HAYLEY DDS - IAM DES MOINES 50314 UNION Male Accepted FC 9/10/2013

POLK HARVEY, HAYLEY DDS - IAM DES MOINES 50314 POLK Female Accepted FC 9/6/2013

POLK HARVEY, HAYLEY DDS - IAM DES MOINES 50314 POLK Not Asked Active 9/24/2013

POLK HARVEY, HAYLEY DDS - IAM DES MOINES 50314 POLK Not Asked Active 9/24/2013

POLK HARVEY, HAYLEY DDS - IAM DES MOINES 50314 POLK Not Asked Unreachable 9/17/2013

POLK HARVEY, HAYLEY DDS - IAM DES MOINES 50314 POLK Not Asked Unreachable 9/18/2013

POLK HARVEY, HAYLEY DDS - IAM DES MOINES 50314 POLK Not Asked Unreachable 9/4/2013

POLK HARVEY, HAYLEY DDS - IAM DES MOINES 50314 POLK Male Unreachable 9/12/2013

POLK HOLM, ERIC DR - IAM DES MOINES 50309 POLK Female Accepted FC 9/20/2013

POLK HORNBROOK, KAY DO - IAM ANKENY 50023 POLK Female Accepted FC 9/12/2013

POLK KOPP, JASON DR - IAM DES MOINES 50314 POLK Female Accepted FC 9/16/2013

POLK KRUGLER, BARB - IAM DES MOINES 50314 MARION Female Accepted FC 9/13/2013

POLK KRUGLER, BARB - IAM DES MOINES 50314 POLK Not Asked Unreachable 9/20/2013

POLK LANDEEN, CAROLINA - IAM DES MOINES 50314 POLK Male Accepted FC 9/27/2013

POLK LONG, CASSIDY DO - IAM DES MOINES 50314 POLK Female Accepted FC 9/6/2013

POLK MADSON, BRANDON DR - IAM DES MOINES 50316 POLK Male Accepted FC 9/16/2013

POLK MADSON, BRANDON DR - IAM DES MOINES 50316 POLK Not Asked Active 9/27/2013

POLK MATSON, CHRISTOPHER DO - IAM DES MOINES 50314 WAYNE Female Accepted FC 9/18/2013

POLK MATSON, CHRISTOPHER DO - IAM DES MOINES 50314 STORY Female Accepted FC 9/4/2013

POLK MATSON, CHRISTOPHER DO - IAM DES MOINES 50314 GUTHRIE Male Accepted FC 9/13/2013

POLK MATSON, CHRISTOPHER DO - IAM DES MOINES 50314 POLK Male Accepted FC 9/10/2013

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Clinic County Clinic Name Clinic City Clinic Zip Participant

County

Participant

Gender

Enrollment Status Fax Received Date

POLK MATSON, CHRISTOPHER DO - IAM DES MOINES 50314 WAYNE Female Accepted FC 9/29/2013

POLK MATSON, CHRISTOPHER DO - IAM DES MOINES 50314 POLK Male Unreachable 9/13/2013

POLK MATSON, CHRISTOPHER DO - IAM DES MOINES 50314 POLK Not Asked Unreachable 9/13/2013

POLK MCCUBBIN, MICHAEL - IAM DES MOINES 50314 POLK Male Accepted FC 9/3/2013

POLK MCCURDY, ELIZABETH - IAM WEST DES MOINES 50265 POLK Male Accepted FC 9/16/2013

POLK MITCHELL, AMY - IAM ANKENY 50023 POLK Female Accepted FC 9/16/2013

POLK MOLAKAH, NEETHA MD - IAM DES MOINES 50314 POLK Male Accepted FC 9/6/2013

POLK MURALIDHARA, SAM - IAM DES MOINES 50314 POLK Female Accepted FC 9/16/2013

POLK NERHEIM, PAMELA - IAM DES MOINES 50309 CLARKE Female Accepted FC 9/9/2013

POLK ORI-HONEYCUTT, ELAINA DO - IAM DES MOINES 50314 POLK Female Accepted FC 9/9/2013

POLK PALAKURTHY, UMA MD - IAM DES MOINES 50320 POLK Female Accepted FC 9/11/2013

POLK PARKER, DEB FUPC - IAM DES MOINES 50317 POLK Female Accepted FC 9/16/2013

POLK PARKER, DEB FUPC - IAM DES MOINES 50317 POLK Female Accepted FC 9/25/2013

POLK PARKER, DEB FUPC - IAM DES MOINES 50317 POLK Female Unreachable 9/11/2013

POLK PETERSON, WILLIAM TRENT - IAM DES MOINES 50327 POLK Female Accepted FC 9/6/2013

POLK PRIMARY HEALTH CARE DES MOINES 50314 POLK Not Asked Active 9/24/2013

POLK REMINGTON, SHANNON DR - IAM DES MOINES 50314 POLK Female Accepted FC 9/24/2013

POLK REMINGTON, SHANNON DR - IAM DES MOINES 50314 STORY Female Accepted FC 9/10/2013

POLK REMINGTON, SHANNON DR - IAM DES MOINES 50314 POLK Not Asked Active 9/24/2013

POLK ROBINSON, ARA DR - IAM DES MOINES 50309 POLK Male Accepted FC 9/19/2013

POLK ROBINSON, ARA DR - IAM DES MOINES 50309 POLK Not Asked Active 9/24/2013

POLK ROOK-ROTH, CATHERINE - IAM DES MOINES 50309 POLK Female Accepted FC 9/25/2013

POLK ROOK-ROTH, CATHERINE - IAM DES MOINES 50309 JASPER Female Accepted FC 9/25/2013

POLK SCHAEFER, AMANDA MD - IAM DES MOINES 50314 POLK Male Accepted FC 9/28/2013

POLK SEFCIK, SARA PAC - IAM DES MOINES 50309 POLK Female Accepted FC 9/5/2013

POLK SEVERIDT, LARRY DR - IAM DES MOINES 50314 POLK Female Accepted FC 9/24/2013

POLK SIXTA, DEBRA - IAM ALTOONA 50009 POLK Male Accepted FC 9/17/2013

POLK STEINMANN, LORI ARNP - IAM DES MOINES 50309 POLK Female Accepted FC 9/9/2013

POLK STRANG, STEVEN DR - IAM PLEASANT HILL POLK Female Accepted FC 9/16/2013

POLK STUBBLEFIELD, JOSHUA - IAM DES MOINES 50314 POLK Female Accepted FC 9/4/2013

POLK VAZQUEZ, ERNESTO - IAM DES MOINES 50314 POLK Female Accepted FC 9/13/2013

POLK VOGEL, JULIE DO - IAM DES MOINES 50309 POLK Male Accepted FC 9/24/2013

POLK YOUNG, SHERYL ARNP - IAM DES MOINES 50315 POLK Female Accepted FC 9/4/2013

POLK YOUNG, SHERYL ARNP - IAM DES MOINES 50315 POLK Female Accepted FC 9/6/2013

Pottawattamie RYGOL, SARA PAC - IAM HARRISON Male Accepted FC 9/24/2013

Pottawattamie JONES, CHRISTIAN - IAM COUNCIL BLUFFS POTTAWATTAMI

E

Male Accepted FC 9/27/2013

Pottawattamie MCELDERRY, THOMAS DR - IAM COUNCIL BLUFFS POTTAWATTAMI

E

Not Asked Unreachable 9/10/2013

POTTAWATTAMI

E

ALEGENT PSYCHIATRIC ASSOCIATES COUNCIL BLUFFS 51503 POTTAWATTAMI

E

Not Asked Declined FC 9/19/2013

POTTAWATTAMI

E

BREWER, CAMILLE - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Female Accepted FC 9/3/2013

POTTAWATTAMI

E

BREWER, CAMILLE - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Not Asked Unreachable 9/5/2013

POTTAWATTAMI

E

BREWER, CAMILLE, APRN - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Male Accepted FC 9/16/2013

POTTAWATTAMI

E

BREWER, CAMILLE, APRN - IAM COUNCIL BLUFFS 51501 ADAMS Male Accepted FC 9/16/2013

POTTAWATTAMI

E

BREWER, CAMILLE, APRN - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Female Accepted FC 9/24/2013

POTTAWATTAMI

E

BREWER, CAMILLE, APRN - IAM COUNCIL BLUFFS 51501 MILLS Not Asked Unreachable 9/13/2013

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Clinic County Clinic Name Clinic City Clinic Zip Participant

County

Participant

Gender

Enrollment Status Fax Received Date

POTTAWATTAMI

E

DOWLING, TERESA MD - IAM COUNCIL BLUFFS 51501 MONTGOMERY Female Accepted FC 9/23/2013

POTTAWATTAMI

E

DOWLING, TERESA MD - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Male Accepted FC 9/19/2013

POTTAWATTAMI

E

DOWLING, TERESA MD - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Female Declined FC 9/13/2013

POTTAWATTAMI

E

GARCIA-DORTA, LINDA DR - IAM COUNCIL BLUFFS 51503 POTTAWATTAMI

E

Male Accepted FC 9/9/2013

POTTAWATTAMI

E

GARCIA-DORTA, LINDA DR - IAM COUNCIL BLUFFS 51503 POTTAWATTAMI

E

Female Accepted FC 9/23/2013

POTTAWATTAMI

E

GARCIA-DORTA, LINDA DR - IAM COUNCIL BLUFFS 51503 SHELBY Female Active 9/27/2013

POTTAWATTAMI

E

MARAR, DIANA - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Female Accepted FC 9/13/2013

POTTAWATTAMI

E

MARAR, ISAM MD - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Not Asked Active 9/25/2013

POTTAWATTAMI

E

MCELDERRY, THOMAS - IAM COUNCIL BLUFFS 51503 POTTAWATTAMI

E

Male Accepted FC 9/27/2013

POTTAWATTAMI

E

MONASTER, BARCLAY - IAM COUNCIL BLUFFS 51503 POTTAWATTAMI

E

Male Accepted FC 9/27/2013

POTTAWATTAMI

E

SEIF, ABOU DR- IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Male Accepted FC 9/17/2013

POTTAWATTAMI

E

STEARNES, RACHAEL - IAM COUNCIL BLUFFS 51503 POTTAWATTAMI

E

Not Collected Accepted FC 9/10/2013

POTTAWATTAMI

E

STEARNES, RACHAEL - IAM COUNCIL BLUFFS 51503 POTTAWATTAMI

E

Not Collected Declined FC 9/27/2013

POTTAWATTAMI

E

SWAN, JOSALYNN PA - IAM COUNCIL BLUFFS 51503 Not Asked Active 9/27/2013

POTTAWATTAMI

E

TOOMBS-WITHERS, SHAYLA MD - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Female Accepted FC 9/10/2013

POTTAWATTAMI

E

TOOMBS-WITHERS, SHAYLA MD - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Female Accepted FC 9/4/2013

POTTAWATTAMI

E

TOOMBS-WITHERS, SHAYLA MD - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Female Unreachable 9/4/2013

POTTAWATTAMI

E

WANZEK III, JOSEPH DO - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Female Accepted FC 9/9/2013

POTTAWATTAMI

E

WANZEK III, JOSEPH DO - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Female Accepted FC 9/16/2013

POTTAWATTAMI

E

WANZEK III, JOSEPH DO - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Male Accepted FC 9/16/2013

POTTAWATTAMI

E

WANZEK III, JOSEPH DO - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Female Accepted FC 9/27/2013

POTTAWATTAMI

E

WANZEK III, JOSEPH DO - IAM COUNCIL BLUFFS 51501 POTTAWATTAMI

E

Not Asked Unreachable 9/9/2013

Poweshiek GRINNELL REGIONAL INTERNAL MEDICINE POWESHIEK Not Asked Unreachable 9/19/2013

POWESHIEK MCNAUL, MINDY - IAM MONTEZUMA 50171 POWESHIEK Female Accepted FC 9/27/2013

POWESHIEK PHELPS, K PAC - IAM GRINNELL 50112 POWESHIEK Female Accepted FC 9/25/2013

POWESHIEK PHELPS, K PAC - IAM GRINNELL 50112 POWESHIEK Male Accepted FC 9/25/2013

RINGGOLD MAYERS, MIKE DR - IAM MOUNT AYR 50854 RINGGOLD Female Accepted FC 9/20/2013

SAC BLESSINGTON, KAY ARNP - IAM LAKE VIEW 51450 SAC Female Accepted FC 9/27/2013

Scott ARNOLD, DANIEL - IAM SCOTT Female Active 9/25/2013

Scott EDGERTON WOMEN'S HEALTH SCOTT Not Asked Unreachable 9/20/2013

Scott ROWLANDS, VICTORIA ARNP - IAM BETTENDORF SCOTT Female Accepted FC 9/9/2013

SCOTT COMMUNITY HEALTH CARE DAVENPORT 52801 SCOTT Not Asked Declined FC 9/24/2013

SCOTT COMMUNITY HEALTH CARE DAVENPORT 52801 SCOTT Male Declined FC 9/16/2013

SCOTT DODDS, KARI DR - IAM DAVENPORT 52804 SCOTT Female Accepted FC 9/27/2013

SCOTT GROSS, BRIAN - IAM DAVENPORT 52807 SCOTT Female Accepted FC 9/6/2013

SCOTT GROSS, BRIAN - IAM DAVENPORT 52807 SCOTT Female Accepted FC 9/6/2013

SCOTT GROSS, BRIAN - IAM DAVENPORT 52807 CLINTON Male Accepted FC 9/13/2013

SCOTT GUDGEL, ELIZABETH ARNP - IAM DAVENPORT 52801 SCOTT Female Accepted FC 9/3/2013

SCOTT GUDGEL, ELIZABETH ARNP - IAM DAVENPORT 52801 SCOTT Female Accepted FC 9/18/2013

SCOTT GUDGEL, ELIZABETH ARNP - IAM DAVENPORT 52801 SCOTT Not Asked Unreachable 9/10/2013

SCOTT HARTMANN, PAUL - IAM DAVENPORT 52806 SCOTT Male Accepted FC 9/25/2013

SCOTT HEMATOLOGY ONCOLOGY ASSOC OF THE

QUAD CITIES

BETTENDORF 52722 SCOTT Not Asked Unreachable 9/12/2013

SCOTT HONG, ARTHUR - IAM DAVENPORT 52804 SCOTT Male Accepted FC 9/6/2013

SCOTT ISMAIL, HAMZA MD - IAM DAVENPORT 52804 LINN Female Accepted FC 9/13/2013

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Clinic County Clinic Name Clinic City Clinic Zip Participant

County

Participant

Gender

Enrollment Status Fax Received Date

SCOTT JAURON, SARAH - IAM DAVENPORT 52801 Not Asked Active 9/27/2013

SCOTT KASPER, STACIE DR - IAM DAVENPORT 52804 SCOTT Not Asked Unreachable 9/19/2013

SCOTT KELLY, MICHAEL MD - IAM DAVENPORT 52802 SCOTT Male Accepted FC 9/18/2013

SCOTT KOLAWOLE, OLA - IAM DAVENPORT 52802 SCOTT Female Accepted FC 9/17/2013

SCOTT KUMAR, POMILLA MD - IAM BETTENDORF 52722 SCOTT Female Accepted FC 9/25/2013

SCOTT METUGE, ANNE DR - IAM DAVENPORT 52801 SCOTT Male Accepted FC 9/27/2013

SCOTT METUGE, ANNE DR - IAM DAVENPORT 52801 SCOTT Male Accepted FC 9/18/2013

SCOTT METUGE, ANNE DR - IAM DAVENPORT 52801 SCOTT Male Accepted FC 9/11/2013

SCOTT METUGE, ANNE DR - IAM DAVENPORT 52801 SCOTT Not Asked Unreachable 9/11/2013

SCOTT MORRISON, JASMIN - IAM DAVENPORT 52804 SCOTT Female Accepted FC 9/10/2013

SCOTT MORRISON, JASMIN - IAM DAVENPORT 52804 SCOTT Female Accepted FC 9/27/2013

SCOTT NELSON, GENEVIEVE ARNP - IAM DAVENPORT 52804 SCOTT Female Accepted FC 9/19/2013

SCOTT PAISLEY, ALISA DAVENPORT 52807 SCOTT Not Asked Unreachable 9/23/2013

SCOTT PERSSON, MICHAEL DR - IAM DAVENPORT 52806 SCOTT Not Asked Active 9/27/2013

SCOTT RICANTE, EDUARDO DR DAVENPORT 52803 SCOTT Female Accepted FC 9/16/2013

SCOTT SCHLOTFELDT, RONALD BRENT DR - IAM BETTENDORF 52722 SCOTT Female Accepted FC 9/18/2013

SCOTT SCHLOTFELDT, RONALD BRENT DR - IAM BETTENDORF 52722 SCOTT Not Asked Active 9/25/2013

SCOTT SCHLOTFELDT, RONALD BRENT DR - IAM BETTENDORF 52722 SCOTT Not Asked Unreachable 9/23/2013

SCOTT SEEMANN, CHRISTEL DO - IAM DAVENPORT 52802 SCOTT Not Asked Active 9/27/2013

SCOTT SHARIS, PETER MD - IAM DAVENPORT 52803 SCOTT Female Accepted FC 9/24/2013

SCOTT SHAW, NATHAN DR DAVENPORT 52804 Not Asked Unreachable 9/13/2013

SCOTT SMITH, CHARLES DO - IAM LE CLAIRE 52753 SCOTT Not Asked Unreachable 9/13/2013

SCOTT WONG, HUMPHREY - IAM DAVENPORT 52807 SCOTT Female Accepted FC 9/20/2013

SHELBY POLDBERG, CALLA HARLAN 51537 SHELBY Female Accepted FC 9/19/2013

SHELBY POLDBERG, CALLA HARLAN 51537 SHELBY Female Unreachable 9/10/2013

South Dakota PAYNE, AMY - IAM DAKOTA DUNES WOODBURY Not Asked Unreachable 9/19/2013

STORY CARANO, RICHARD - IAM AMES 50010 BOONE Not Asked Unreachable 9/17/2013

STORY GOLDSBERRY, JODI - IAM AMES 50010 STORY Male Accepted FC 9/14/2013

STORY GOLDSBERRY, JODI - IAM AMES 50010 STORY Male Unreachable 9/10/2013

STORY KATRAYADDA, SRIKANTH - IAM AMES 50010 STORY Not Asked Unreachable 9/17/2013

UNION OPHEIM, KATHRYN MD - IAM NORTH SIOUX CITY 57049 WOODBURY Male Accepted FC 9/16/2013

UNION REMER, LISA DR - IAM NORTH SIOUX CITY 57049 WOODBURY Female Accepted FC 9/10/2013

WAPELLO BRANNEN, JEFF DO - IAM OTTUMWA 52501 WAPELLO Female Accepted FC 9/11/2013

WAPELLO BRANNEN, JEFF DO - IAM OTTUMWA 52501 WAPELLO Female Accepted FC 9/19/2013

WAPELLO BROWN, KIM - IAM OTTUMWA 52501 WAPELLO Female Accepted FC 9/25/2013

WAPELLO BUTLER, VERONICA DR - IAM OTTUMWA 52501 WAPELLO Female Accepted FC 9/19/2013

WAPELLO BUTLER, VERONICA DR - IAM OTTUMWA 52501 WAPELLO Not Asked Unreachable 9/10/2013

WAPELLO FRANKE, MOLLY PAC - IAM OTTUMWA 52501 WAPELLO Not Asked Unreachable 9/19/2013

WAPELLO O'BRIEN, JUANITA ARNP - IAM OTTUMWA 52501 WAPELLO Female Accepted FC 9/12/2013

WAPELLO PIERSON, RYAN DR - IAM OTTUMWA 52501 WAPELLO Female Accepted FC 9/12/2013

WAPELLO RAVURI, SUREN - IAM OTTUMWA 52501 WAPELLO Female Accepted FC 9/5/2013

WAPELLO SHELTON, KATHRYN ARNP - IAM OTTUMWA 52501 JEFFERSON Male Accepted FC 9/20/2013

WAPELLO VAN MAANEN, HEIDI - IAM OTTUMWA 52501 WAPELLO Male Accepted FC 9/18/2013

Page 13: Clinic County Clinic Name Clinic City Clinic Zip ... 2013 F… · BREMER EDEKER, JENNIFER ARNP - IAM DENVER 50622 BREMER Not Asked Unreachable 9/6/2013 BREMER WAVERLY HEALTH CENTER

Clinic County Clinic Name Clinic City Clinic Zip Participant

County

Participant

Gender

Enrollment Status Fax Received Date

WAPELLO WALKER, KIM ARNP - IAM OTTUMWA 52501 HENRY Female Active 9/27/2013

Warren WERLING, RYAN - IAM INDIANOLA WARREN Female Accepted FC 9/20/2013

WARREN BICE, JAMES INDIANOLA 50125 WARREN Not Asked Declined FC 9/9/2013

WARREN MORAN, ROBERT - IAM INDIANOLA 50125 WARREN Female Accepted FC 9/20/2013

WASHINGTON BEDELL, DAVID - IAM RIVERSIDE 52327 JOHNSON Female Accepted FC 9/6/2013

WASHINGTON LANTERNIER, NATALIE - IAM RIVERSIDE 52327 WASHINGTON Female Accepted FC 9/25/2013

WASHINGTON NEUKIRCH, NEALY - IAM RIVERSIDE 52327 WASHINGTON Not Asked Unreachable 9/3/2013

WEBSTER ANDERSON, DEBRA - IAM FORT DODGE 50501 WEBSTER Female Accepted FC 9/19/2013

WEBSTER ANDERSON, DEBRA - IAM FORT DODGE 50501 WRIGHT Female Accepted FC 9/19/2013

WEBSTER ANDERSON, DEBRA - IAM FORT DODGE 50501 WEBSTER Male Accepted FC 9/19/2013

WEBSTER ANDERSON, DEBRA - IAM FORT DODGE 50501 WEBSTER Not Asked Active 9/24/2013

WEBSTER ANDERSON, DEBRA - IAM FORT DODGE 50501 WEBSTER Not Asked Unreachable 9/19/2013

WEBSTER ANDERSON, DEBRA - IAM FORT DODGE 50501 WEBSTER Male Unreachable 9/19/2013

WEBSTER CHASE, LISA ARNP - IAM FORT DODGE 50501 WEBSTER Female Accepted FC 9/27/2013

WEBSTER CHASE, LISA ARNP - IAM FORT DODGE 50501 CALHOUN Female Accepted FC 9/11/2013

WEBSTER COMMUNITY HEALTH CENTER FORT DODGE 50501 WEBSTER Male Accepted FC 9/27/2013

WEBSTER DUFFY, JILL - IAM FORT DODGE 50501 WEBSTER Female Accepted FC 9/25/2013

WEBSTER DUFFY, JILL - IAM FORT DODGE 50501 Not Asked Unreachable 9/11/2013

WEBSTER DUFFY, JILL - IAM FORT DODGE 50501 WEBSTER Not Asked Unreachable 9/12/2013

WEBSTER DUFFY, JILL - IAM FORT DODGE 50501 WEBSTER Not Asked Unreachable 9/4/2013

WEBSTER MINION, RANDY MD - IAM FORT DODGE 50501 Not Asked Unreachable 9/6/2013

WEBSTER SECOR, JANET DR - IAM FORT DODGE 50501 WEBSTER Female Accepted FC 9/13/2013

WEBSTER SMITH, APRIL ARNP - IAM FORT DODGE 50501 WEBSTER Female Accepted FC 9/3/2013

WEBSTER STITT, MICHAEL MD - IAM FORT DODGE 50501 WEBSTER Male Accepted FC 9/27/2013

WEBSTER WEBSTER COUNTY HEALTH DEPT FORT DODGE 50501 WEBSTER Female Accepted FC 9/6/2013

WEBSTER WEBSTER COUNTY HEALTH DEPT FORT DODGE 50501 WEBSTER Not Asked Unreachable 9/13/2013

WOODBURY CFY - SIOUXLAND DISTRICT HEALTH DEPT SIOUX CITY 51105 WOODBURY Female Accepted FC 9/11/2013

WOODBURY CFY - SIOUXLAND DISTRICT HEALTH DEPT SIOUX CITY 51105 CHEROKEE Female Accepted FC 9/10/2013

WOODBURY CFY - SIOUXLAND DISTRICT HEALTH DEPT SIOUX CITY 51105 WOODBURY Female Accepted FC 9/16/2013

WOODBURY CFY - SIOUXLAND DISTRICT HEALTH DEPT SIOUX CITY 51105 CHEROKEE Not Asked Unreachable 9/19/2013

WOODBURY EARLYWINE, MOLLY PAC - IAM SIOUX CITY 51102 WOODBURY Female Accepted FC 9/4/2013

WOODBURY GUERDAT, RANDY PAC - IAM SIOUX CITY 51104 WOODBURY Female Accepted FC 9/3/2013

WOODBURY GUTHMILLER, CINDY ARNP - IAM SIOUX CITY 51102 WOODBURY Female Accepted FC 9/23/2013

WOODBURY HATTAN, GARY DR - IAM SIOUX CITY 51105 WOODBURY Female Accepted FC 9/25/2013

WOODBURY HEATON, JULIA DR - IAM SIOUX CITY 51102 OBRIEN Female Accepted FC 9/9/2013

WOODBURY JACOBS, CHRISTOPHER - IAM SIOUX CITY 51102 Not Asked Unreachable 9/4/2013

WOODBURY JOYCE, STEVEN DR - IAM SIOUX CITY 51101 WOODBURY Female Accepted FC 9/27/2013

WOODBURY KRAUSE, LORI - IAM SIOUX CITY 51102 WOODBURY Female Accepted FC 9/19/2013

WOODBURY LAFLEUR, SHAUNA - IAM SIOUX CITY 51104 WOODBURY Female Accepted FC 9/10/2013

WOODBURY MERCY SINGING HILLS FAMILY MEDICINE SIOUX CITY 51106 WOODBURY Female Accepted FC 9/11/2013

WOODBURY PICK, ANN ARNP SIOUX CITY 51105 WOODBURY Female Accepted FC 9/25/2013

WOODBURY PRINCE, DANIELLE MD - IAM SIOUX CITY 51102 WOODBURY Female Accepted FC 9/16/2013

WOODBURY PRINCE, DANIELLE MD - IAM SIOUX CITY 51102 WOODBURY Female Accepted FC 9/17/2013

WOODBURY ROSENKRANS, KURT DR - IAM SIOUX CITY 51104 WOODBURY Male Accepted FC 9/6/2013

Page 14: Clinic County Clinic Name Clinic City Clinic Zip ... 2013 F… · BREMER EDEKER, JENNIFER ARNP - IAM DENVER 50622 BREMER Not Asked Unreachable 9/6/2013 BREMER WAVERLY HEALTH CENTER

Clinic County Clinic Name Clinic City Clinic Zip Participant

County

Participant

Gender

Enrollment Status Fax Received Date

WOODBURY WALZ, KRISTI - IAM SIOUX CITY 51102 PLYMOUTH Not Asked Unreachable 9/13/2013

WOODBURY WURTH, RACHEL - IAM SIOUX CITY 51102 WOODBURY Female Accepted FC 9/17/2013

WOODBURY WURTH, RACHEL - IAM SIOUX CITY 51102 WOODBURY Male Accepted FC 9/17/2013