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Release print
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#	Item
581	AUTHORIZATION TO RELEASE HEALTH CARE INFORMATION This authorization expires 90 days from date signed PATIENT INFORMATION: __________________________________________________________________________________________ Print n Add to Reading List Source URL: www.fcphd.org Language: English - Date: 2013-11-26 13:41:16 Medical informatics Sexually transmitted diseases and infections Medical record Release of information department AIDS Power of attorney Medical privacy HIV Health Insurance Portability and Accountability Act Health Medicine HIV/AIDS
582	The important work of the Earn It! Keep It! Save It! (EKS) Coalition in Sonoma, Lake, and Mendocino counties is made possible by the collaboration of partners such as you. As your agency’s representative to the EKS Coa Add to Reading List Source URL: www.unitedwaywinecountry.org Language: English - Date: 2013-08-29 17:32:53 IRS tax forms Release print Tax preparation Government Public administration Public economics Taxation in the United States Internal Revenue Service Revenue services
583	GENERAL AUTHORIZATION FOR RELEASE OF INFORMATION TO THE TENNESSEE DEPARTMENT OF HUMAN SERVICES Information will be released for: PRINT NAME► Date: Add to Reading List Source URL: state.tn.us Language: English - Date: 2007-04-25 16:22:05 Internet privacy Medical record Law Health Medicine Privacy law Data privacy Health Insurance Portability and Accountability Act
584	Print Form Course Buy Out Confirmation Form Faculty of Arts & Social Sciences Release Year Add to Reading List Source URL: carleton.ca - Date: 2013-08-19 16:26:13
585	PRINT CLEAR CONSENT FOR RELEASE OF INFORMATION Add to Reading List Source URL: www.fmo.hawaii.edu Language: English - Date: 2013-12-18 18:08:18 Loan Honolulu County Hawaii Hawaii Authorization
586	PRIVACY ACT RELEASE FORM PLEASE PRINT CLEARLY Mr./Mrs./Ms. Full Name:__________________________________________ Nick Name:_____________ Add to Reading List Source URL: www.johnboehner.house.gov Language: English - Date: 2014-02-07 13:40:00 Internet privacy Privacy Act Privacy United States House of Representatives Ethics John Boehner
587	Print the following form, obtain appropriate signatures and Email signed copy to: Dwight Crabtree PHOTO RELEASE I, Add to Reading List Source URL: www.nd.gov Language: English - Date: 2013-02-08 10:46:14 States of the United States North Dakota Department of Career and Technical Education North Dakota
588	PARTICIPANT AGREEMENT AND RELEASE OF LIABILITY FORM Simplot Games – February 13-15, 2014 Athlete’s Name – Please print clearly Age Add to Reading List Source URL: simplotgames.com Language: English - Date: 2013-12-27 14:59:19 Economy of the United States Simplot Games Simplot Track and field
589	2014 Collegiate Leadership Academy Registration & Release Form (please print neatly) (Turn in on-site for all students and advisors attending.) School: State/Province: EMAIL and MAJOR Add to Reading List Source URL: www.deca.org - Date: 2014-08-11 15:53:57
590	GENERAL RELEASE AND AGREEMENT THIS GENERAL RELEASE AND AGREEMENT ("Agreement) is made this _____/_____/_____ by and between _________________________(hereinafter Print Your Name Add to Reading List Source URL: www.homelandpreparedness.org Language: English* - Date: 2012-02-16 14:07:56 Severability Contract law Legal terms Integration clause

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