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Katz Counseling and Educational Psychology 12791 World Plaza Lane, ×89 Fort Myers, FL 33907 Phone: (239×2471756 www.katzpsychology.com CONSENT FOR RELEASE OF CONFIDENTIAL INFORMATION I, (Print Client,

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What is consent for release of?

Consent for release of is a form that allows an individual to authorize the disclosure of their personal information to a third party.

Who is required to file consent for release of?

Any individual who wishes to authorize the release of their personal information to a third party is required to file consent for release of.

How to fill out consent for release of?

To fill out consent for release of, the individual must provide their personal information, the recipient's information, specify what information can be released, and sign the form.

What is the purpose of consent for release of?

The purpose of consent for release of is to protect an individual's privacy by ensuring that their personal information is only disclosed with their explicit permission.

What information must be reported on consent for release of?

Information such as the individual's name, contact information, the recipient's information, and the type of information that can be released must be reported on the consent for release of form.

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