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Full name of Employee or Legal Representative Signature of Employee or Legal Representative Date of Signature // MMV-MMXVI Mancomm. Appendix A Sample Authorization Letter for the Release of Employee Medical Record Information to a Designated Representative I full name of worker/patient hereby authorize individual or organization holding the medical records to release to individual or organization authorized to receive the medical information the following medical information from my personal...
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MANCOMM OSHA Books DOT provides a variety of resources for safety and compliance in the workplace.
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