AUTHORIZATION FOR RELEASE ACQUISITION OF PATIENT INFORMATION The undersigned hereby authorizes ___________________________________________ Local Health Department Whose address is________________________________________ - Patient abuse - Document - PDFSEARCH.IO

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	AUTHORIZATION FOR RELEASE/ACQUISITION OF PATIENT INFORMATION The undersigned hereby authorizes ___________________________________________ Local Health Department Whose address is________________________________________ Add to Reading List Document Date: 2014-08-21 20:24:48 Open Document File Size: 27,00 KB Share Result on Facebook Company PATIENT INFORMATION / / Facility Facility Name Facility Address Information / / MedicalCondition drug abuse / HIV/ AIDS / alcohol abuse / / Organization Local Health Department Agency / / Person Parent / / SocialTag Legal documents Pharmacology Abuse Medical ethics Healthcare law

AUTHORIZATION FOR RELEASE/ACQUISITION OF PATIENT INFORMATION The undersigned hereby authorizes ___________________________________________ Local Health Department Whose address is________________________________________Add to Reading List