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AUTHORIZATION TO RELEASE TEST SCORES FORM Level land Campus Testing Office 1401 S. College Avenue Level land, TX 79336 Phone: 806.716.2367, 806.716.2530 Brant southplainscollege.edu Reese Center Testing
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How to fill out authorization to release test:

01
Start by providing your personal information, including your full name, date of birth, and contact details.
02
Clearly state the purpose for which you are authorizing the release of your test results. Specify if it is for medical purposes, educational purposes, or any other specific reason.
03
Indicate the specific tests or medical information that you are authorizing to be released. Be as specific as possible to ensure accuracy.
04
Include the start and end dates for which the authorization is valid. This is important to ensure that the release of your test results is timely and within the intended period.
05
Sign and date the authorization form. Your signature serves as your consent and acknowledges that you understand the implications of releasing your test results.
06
Keep a copy of the completed authorization form for your records.

Who needs authorization to release test?

01
Patients who wish to share their test results with specific individuals or organizations, such as healthcare providers, educational institutions, or employers, may require authorization to release the test.
02
Research institutions or organizations that need access to test results for studies or analysis may also need authorization from the individuals being tested.
03
In some cases, legal authorities or court orders may require authorization to release certain test results as part of an ongoing investigation or legal proceeding.
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Authorization to release test is a form or document that allows a specific individual or organization to access and release test results or information.
Anyone who needs to provide or obtain test results or information on behalf of an individual or organization may be required to file authorization to release test.
Authorization to release test can typically be filled out by providing personal details, specifying the information to be released, and signing the form to authorize the release.
The purpose of authorization to release test is to protect the privacy and confidentiality of test results or information by ensuring that only authorized individuals or organizations have access to them.
The information that must be reported on authorization to release test may include the name of the individual authorizing the release, the specific information to be released, and any restrictions or conditions on the release.
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