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CENTER FOR EMOTIONALLY FOCUSED THERAPY 8045 W. Grand ridge Blvd. Suite A Carol Ann Conrad MS MHC Kennewick WA 99336 509 735 1221 Fax 5097355364 Martha McCrory MSW LCSW Cynthia Benson, MS, LEFT, NCA
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Releaseofinformationroi3-11-20081doc is a document used to authorize the disclosure of specific information to a designated individual or entity.
The individual or entity seeking to obtain specific information from a healthcare provider or organization is required to file releaseofinformationroi3-11-20081doc.
To fill out releaseofinformationroi3-11-20081doc, one must provide their personal information, specify the information to be disclosed, and authorize the release of information by signing the document.
The purpose of releaseofinformationroi3-11-20081doc is to ensure that sensitive information is disclosed only to authorized individuals or entities for the intended purpose.
Releaseofinformationroi3-11-20081doc must include the requester's name, contact information, specific information to be disclosed, the purpose of the disclosure, and any additional instructions or limitations.
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