Form 8 Consent for Release of Confidential Health and / or Mental Health Information - Virginia
Form 11 Consent for Release of Confidential Health and/or Mental Health Information (Inactive Inmate Only) - Virginia
Permission to Release Confidential Information to Secure Necessary Services - Housing Opportunities for Persons With Aids
Permission Template to Release Medical Treatment Facility Records
Form 14 Consent for Release of Information - Virginia
DD Form 3130 Consent for the Disclosure of Confidential Substance Use Information
DD Form 2832 Release Granting U.S. Government Permission to Photograph or Otherwise Record the Visual Image or Sound of Private Property
DD Form 2833 Release Granting the United States Government Permission to Record and Reproduce Program Material Transmitted by Educational or Commercial Broadcast Stations
Form SSA-3288 Consent for Release of Information
NA Form 10003 Consent to Make Inquiries and Release of Information and Records
59 MDW Form 46 Mental Health Clinic/Confidentiality Informed Consent for Child and Adolescent Mental Health Services
Formulario SSA-3288-SP Consentimiento Para Divulgar Informacion (Spanish)
Form DS-5505 Written Consent to Release of Personal Information Under the Privacy Act
NAVPERS Form 1000/32 Consent to Release Personal Contact Information
Form CMS-10106 Authorization to Disclose Personal Health Information Release Form
Form CMS-R-0235 Data Use Agreement (Dua) (Agreement for Use of Centers for Medicare and Medicaid Services (Cms) Data Containing Individual Identifiers)
Form CMS-R-0235A Data Use Agreement (Dua) Signature Addendum for Data Acquired From the Centers for Medicare & Medicaid Services (Cms)
DA Form 5018 Asap Client's Consent Statement for Release of Treatment Information
Family Group Conferencing - Consent for Release of Confidential Information - City of Alexandria, Virginia
Form HUD-25015-A Appendix 2 Consent for Release of Patient Information During or After
VA Form 3288 Request for and Consent to Release of Information From Individual's Records
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