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Authorization for Disclosure of Confidential Information Patients Name: Home Phone: Cell Phone: Work Phone: Address: City: State: Zip: Date of Birth: / / SS# / / Authorizes (please circle):EYE ASSOCIATES
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How to fill out date of birth ss

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Start by finding the field labeled 'Date of Birth' on the form or application.
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Who needs date of birth ss?

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Date of Birth information is commonly required in various situations:
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Overall, anyone who needs to verify an individual's age, identity, or eligibility may require date of birth information.
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