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Health Form & Release Form for Grace Lutheran Church Members and Guests for the Year of 2014 Name: Address: City/State: Zip: Phone: DOB: In Case of Emergency notify: Relationship: Home Phone: Work
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Individuals participating in certain activities or events that require a release of liability and health information, such as sports tournaments, fitness competitions, or recreational programs.
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Release-and-health-formpdf is a document used to release information about an individual's health.
Individuals who have authorized the release of their health information are required to file release-and-health-formpdf.
To fill out release-and-health-formpdf, individuals must provide their personal information and sign the authorization to release their health information.
The purpose of release-and-health-formpdf is to allow the disclosure of an individual's health information to specified individuals or entities.
Release-and-health-formpdf must include the individual's name, date of birth, contact information, and details of the information being released.
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