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Release of Information Form EMPLOYERFuture Energy Skills Ltd Suite 3, Level 2, 187 Boundary Rd North Melbourne VIC 3051 P 03 9654 1299 F 03 9329 0014 E inquiries×profile21.com.AU W www.profile21.com.au ABN

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What is release of information form?

Release of information form is a legal document that allows an individual to authorize the disclosure of their protected health information to a third party.

Who is required to file release of information form?

Any individual who wishes to share their protected health information with a third party is required to file a release of information form.

How to fill out release of information form?

To fill out a release of information form, you must provide the required personal information, specify the recipient of the information, and sign the form to authorize the disclosure.

What is the purpose of release of information form?

The purpose of release of information form is to protect the privacy of an individual's health information and ensure that it is only disclosed to authorized parties.

What information must be reported on release of information form?

The release of information form must include the individual's name, date of birth, the information to be disclosed, the purpose of the disclosure, and the recipient of the information.

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