(Reuters) -Activist investor Elliott Investment Management on Tuesday asked Healthcare Trust of America for more clarity regarding the real estate investment trust’s process to examine strategic alternatives, including a potential sale. The letter from Elliott comes weeks after the activist investor urged the company to conduct a strategic review, including the solicitation of bids, citing investor frustration at its longstanding underperformance. Elliott, one of HTA’s largest shareholders, said HTA’s third quarter earnings conference call scheduled for Friday provides an opportunity for HTA to declare a formal review process. HTA, which invests in real estate primarily consisting of medical office buildings, had said in October it communicated details of the hedge fund’s request to its board. The company on Tuesday pointed to the previous statement and said it would provide an update when it reports earnings this week. Elliott said HTA should address key questions such as whether the company is currently conducting a review process during the call. The hedge fund also reiterated shareholders are in support of a sale over a stand-alone growth strategy for the company. Reporting by Amruta Khandekar; Editing by Krishna Chandra Eluri