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UTAH DOH-HFLCRA September 2005 CBS/MIS CONSENT AND RELEASE OF LIABILITY FOR HEALTH FACILITIES INSTRUCTIONS: Please read both sides of this form, PRINT legibly with black in or TYPE completing the

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What is cbsmis consent and release?

CBSMIS consent and release is a legal document that allows CBSMIS to collect, use, and disclose personal information from individuals for specific purposes, while also releasing CBSMIS from liability related to the collection and use of this information.

Who is required to file cbsmis consent and release?

Any individual whose personal information is collected, used, or disclosed by CBSMIS is required to file a cbsmis consent and release form.

How to fill out cbsmis consent and release?

To fill out a cbsmis consent and release form, you need to provide your personal information, read the terms and conditions carefully, and sign the document to indicate your consent and release.

What is the purpose of cbsmis consent and release?

The purpose of cbsmis consent and release is to ensure that CBSMIS has the necessary consent to collect, use, and disclose personal information for specific purposes, while also protecting CBSMIS from liability.

What information must be reported on cbsmis consent and release?

On the cbsmis consent and release form, you need to report your full name, contact information, and any other personal information requested by CBSMIS in order to fulfill the purposes stated in the form.

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