AUTHORIZATION FOR RELEASE OF INFORMATION Patient:_______________________________ TO WHOM IT MAY CONCERN: You are hereby expressly authorized to release and furnish to the State Office of Risk

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Date: 2012-01-27 11:48:39		AUTHORIZATION FOR RELEASE OF INFORMATION Patient:_______________________________ TO WHOM IT MAY CONCERN: You are hereby expressly authorized to release and furnish to the State Office of Risk Add to Reading List Source URL: www.lamar.edu Download Document from Source Website File Size: 106,01 KB Share Document on Facebook