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Authorization for Release of Dental/Health Care Information 1. I, hereby give my consent to Dr. to release to: Name: Address: Email: Kurt E. Shares, DDS PLC Phone: 616-676-2223 7210 Headley, P.O.

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What is authorization for release of?

Authorization for release of is a legal document that allows a person or entity to disclose confidential information to another party.

Who is required to file authorization for release of?

Any individual or entity that wishes to disclose confidential information to another party is required to file authorization for release of.

How to fill out authorization for release of?

To fill out authorization for release of, one must provide their personal information, specify the information to be released, and sign the document.

What is the purpose of authorization for release of?

The purpose of authorization for release of is to legally allow the disclosure of confidential information between parties.

What information must be reported on authorization for release of?

The information that must be reported on authorization for release of includes the personal details of the disclosing party, the recipient of the information, and the specific information to be released.

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