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ERIN JOYCE, PAY. D. Clinical Psychologist (LIC. # PSY25785) (424) 5354126 Joyce drerinjoyce. Authorization for Release of Information Clients Name: DOB: Information to be released: Summary of treatment
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E-authorization for release of is for granting permission for the release of information or data.
Those who are authorized to give consent for the release of information or data.
The form must be completed with accurate information and all required fields must be filled out.
The purpose is to ensure that data or information is not released without proper consent or authorization.
Personal details of the individual giving authorization and details of the information or data being released.
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