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Catherine Pacemaker, OD MS FAO 653 West Central Avenue Delaware, OH 43015 Phone: 740.369.9413 Fax: 740.837.4216 I, give permission to release records for (print name/DOB) Office Name: Fax: Please
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It is important to note that the specific requirements for a caec records release formdocx may vary depending on the organization or jurisdiction. It is always advisable to contact the relevant entity to obtain the correct form and instructions for filling it out.
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CAEC records release formdocx is a document used to authorize the release of records held by the CAEC.
Individuals or organizations seeking access to CAEC records are required to file this form.
The form should be completed with the requester's personal information, details of the records being requested, and the purpose of the request.
The purpose of the form is to authorize the release of records held by the CAEC to an authorized requester.
The form requires details such as the requester's name, contact information, and a description of the records being requested.
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