Your E-Signature Has Been Accepted You have successfully e-signed the following document(s):  Web tracking ID: T121520210003485      View Submitted Application Opens a window for viewing the current enrollment application  Provider/Supplier Name: Normandy Urgent Care Center  Signer Name: Abdur Rauf  Role: AUTHORIZED OFFICIAL  Document: AUTHORIZATION STATEMENT FOR ORGANIZATIONS (855R)  Signed Date: Wed Dec 15 17:24:39 EST 2021