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CONSENT FOR THE RELEASE OF CONFIDENTIAL ALCOHOL OR DRUG TREATMENT INFORMATION I, (NAME OF PATIENT) (BIRTHDATE) (NAME OR GENERAL DESIGNATION OF ALCOHOL/DRUG PROGRAM MAKING DISCLOSURE) authorize: (NAME

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What is consent for form release?

Consent for form release is a document that authorizes the release of information contained in a form to a specified individual or entity.

Who is required to file consent for form release?

Any individual or entity who wants to release information from a form to a designated recipient must file consent for form release.

How to fill out consent for form release?

To fill out consent for form release, one must provide their personal information, specify the recipient of the information, and sign and date the document.

What is the purpose of consent for form release?

The purpose of consent for form release is to grant permission for the disclosure of information contained in a form to a specified recipient.

What information must be reported on consent for form release?

The information reported on consent for form release typically includes the name and contact information of the individual authorizing the release, as well as details of the recipient and the specific information being released.

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