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CONSENT TO RELEASE INFORMATION Logan K. Williamson, LPC, LLC In regard to the records of: Name: DOB: SSN: I, consent that Logan K. Williamson, LPC may: Exchange Provide Receive The following information

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What is in regard to form?

In regard to form is a document used to report specific information to the relevant authorities.

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Certain individuals or entities may be required to file in regard to form depending on the specific requirements set by the authorities.

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