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Department of Behavioral Health & Georgia Developmental Disabilities Name of Individual/Consumer/Patient/Applicant Social Security Number AND/OR Date of Birth

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What is authorization for release of?

Authorization for release of is a form that grants permission to disclose or release certain information to a designated individual or entity.

Who is required to file authorization for release of?

Anyone who wants to authorize the release of their personal or confidential information to a third party is required to file authorization for release of.

How to fill out authorization for release of?

Authorization for release of can be filled out by providing the necessary personal information requested on the form and specifying the information to be released and to whom.

What is the purpose of authorization for release of?

The purpose of authorization for release of is to protect the confidentiality of personal information and ensure that it is only disclosed to authorized parties.

What information must be reported on authorization for release of?

Information such as the individual's name, date of birth, social security number, and the specific information to be released must be reported on authorization for release of.

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