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AUTHORIZATION TO DISCLOSE PROTECTED HEALTH INFORMATION1. I hereby give permission to: Counseling, Alcohol and Other Drug Assistance Programs, and Psychiatric Services (CAPS) Medical Services Provider/Counselor
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I hereby give permission is a legal document where an individual grants authorization for a specific action or decision.
Individuals who need to grant formal permission for something to be done on their behalf are required to file i hereby give permission.
To fill out i hereby give permission, one must clearly state the action or decision they are authorizing, provide their name and signature, and include the date.
The purpose of i hereby give permission is to ensure that there is documented consent or authorization for a specific action, decision, or request.
The information reported on i hereby give permission typically includes details of the authorized action, the name of the individual granting permission, the date, and a signature.
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