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Client Name (First, Middle, Last): *Print Neatly* County of Sacramento AUTHORIZATION TO OBTAIN OR RELEASE PROTECTED HEALTH INFORMATION (PHI) CONTACT: Date of Birth: Address: City/State/Zip Code: Phone
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County of Sacramento client is a form or document that needs to be filed by individuals or entities who have clients or customers in Sacramento County.
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Any individual or entity with clients or customers in Sacramento County is required to file the county of Sacramento client form.
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The county of Sacramento client form can be filled out online or by mail. The form typically requires information about the individual or entity's clients or customers in Sacramento County.
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Information such as the name, address, and contact information of clients or customers in Sacramento County may need to be reported on the county of Sacramento client form.
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