Get the free Previous Last Name(s)

AUTHORIZATION FOR DISCLOSURE OF HEALTH INFORMATION/ PATIENT REQUEST FOR ACCESS TO HEALTH INFORMATION Patient Name (Last, First, M.I.) Date of Birth Previous Last Name’s) Home Phone Street Address

How to fill out previous last names

Point by point guide on how to fill out previous last names:

1. Start by locating the section on the form that asks for previous last names. This is usually found in the personal information section or under a specific category such as "name history" or "aliases."
2. Provide accurate information about your previous last names. If you have legally changed your last name in the past, include all the names you have used before the current one. This includes maiden names, names from previous marriages, or any other names you may have legally adopted.
3. Write the previous last names in chronological order, starting with the earliest. It's important to provide the most accurate information possible, so take your time to remember and list all the names you have used in the past. If you are unsure about a specific name or can't remember the exact spelling, it's better to make an educated guess or mention that you are uncertain.
4. If there is limited space to write all your previous last names, use additional paper or attach a separate sheet to the form. Clearly label the extra information and ensure it is securely attached to prevent it from being misplaced.
5. Double-check your work before submitting the form. Make sure you have accurately listed all your previous last names and that the information is legible. Filling out this section correctly is crucial, as it helps establish your identity and avoid any potential confusion or discrepancies in official records.

Who needs previous last names?

1. Individuals going through a name change due to marriage, divorce, or legal reasons. Including all previous last names helps maintain a consistent record of identity and facilitates legal processes.
2. Applicants for official documents such as passports, driver's licenses, or social security cards. Providing previous last names is often required during the application process to ensure accurate identification.
3. Employment candidates undergoing background checks or verification processes. Employers may request previous last names to confirm employment history, education records, or criminal background checks.
4. Insurance companies or financial institutions. Including previous last names may be necessary when applying for policies or opening accounts to prevent fraud or identity theft.
5. Government agencies or immigration services. Individuals seeking immigration or naturalization may be required to provide a comprehensive history of previous last names to verify identity and eligibility.

Remember, it is essential to comply with any specific instructions or requirements provided by the entity requesting the information on previous last names.

For pdfFiller’s FAQs

What is previous last names?

Previous last names refer to any last names that an individual held before their current last name.

Who is required to file previous last names?

Individuals who have legally changed their last name or have used a different last name in the past are required to file their previous last names.

How to fill out previous last names?

To fill out previous last names, individuals can typically include this information on official forms or documents that require their full name history.

What is the purpose of previous last names?

The purpose of providing previous last names is to ensure accurate record-keeping and to confirm a person's identity.

What information must be reported on previous last names?

The information that must be reported on previous last names includes any last names that the individual has legally used in the past.

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