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INFORMED CONSENT AND RELEASE OF INFORMATION AND RECORDS Supplemental SSN I authorize the Department for Community Based Services (DUBS) and the following agencies and individuals:Name of Agency or
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How to fill out informed consent and release

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Provide your personal information such as name, address, phone number, and email.
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Clearly state the purpose and nature of the activity or agreement for which the consent is being given.
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Submit the filled-out informed consent and release to the appropriate authority or organization.

Who needs informed consent and release?

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- Any situation where one party wants the other party to release them from certain liabilities or claims.

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Informed consent and release is a legal document that outlines the risks and benefits of participating in a particular activity, treatment, or study, and gives permission for the individual to proceed.
Informed consent and release must be filed by individuals who are participating in a specific activity, treatment, or study that requires their consent.
To fill out informed consent and release, individuals must carefully read and understand the document, ask any questions they may have, and then sign and date it to indicate their agreement.
The purpose of informed consent and release is to ensure that individuals are fully informed about the risks and benefits of a particular activity, treatment, or study before they decide to participate.
Informed consent and release must include details about the nature of the activity, treatment, or study, the potential risks and benefits, any alternative options, and the individual's rights.
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