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A Department of Elder Affairs Program 4040 Esplanade Way Tallahassee, FL 323997000 888.831.0404 850.414.2377 (F) http://ombudsman.myflorida.com Consent to Release Information Complainant Consent I,
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Fill in your personal information accurately, including your name, address, phone number, and email.
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Complainant consent - ombudsmanmyfloridacom is a form that allows an individual to authorize the Office of the Long-Term Care Ombudsman Program of Florida to investigate and address a complaint on their behalf.
The complainant or the person filing the complaint is required to fill out and file the complainant consent - ombudsmanmyfloridacom form.
To fill out complainant consent - ombudsmanmyfloridacom, the individual needs to provide their personal information, details of the complaint, and authorize the Ombudsman Program to investigate.
The purpose of complainant consent - ombudsmanmyfloridacom is to give permission to the Ombudsman Program to act on behalf of the complainant in addressing their concerns.
Complainant consent - ombudsmanmyfloridacom must include the complainant's name, contact information, details of the complaint, and the complainant's signature authorizing the Ombudsman Program to proceed with the investigation.
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