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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.
Any individual or entity with clients or customers in Sacramento County is required to file the county of Sacramento client form.
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.
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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