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AUTHORIZATION FOR RELEASE OF PROTECTED HEALTH INFORMATION PATIENT Informational:Date of Birth:Address:Phone: City:SENDING ORGANIZATION (Name of the person or facility that will be releasing your information)RECEIVING
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To fill out the name of a form person, follow these steps:
1. Start by accessing the form or document that requires the individual's name.
2. Locate the designated field or section for entering the name.
3. Begin by typing the person's first name in the designated space.
4. If applicable, provide any middle name or initial in the specified field.
5. Finally, enter the last name or surname in the appropriate space.
6. Double-check the entered information for accuracy and ensure proper capitalization.
7. Once satisfied with the provided name, proceed to the next step or submit the form/document as required.
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