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CapstoneWellnessCenterApril2014 MentalHealthPolicies&ProceduresManualCapstoneWellnessCenter AUTHORIZATIONTOREQUESTORRELEASEINFORMATIONClientsName: ClientsAddress: DateofBirth(day/month/year): Iherebyauthorizethefollowingdesignatedofficeorpersonof
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