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HELENE TRUJILLO, LCSW Authorization For Release of Information I, hereby authorize Helene Trujillo, LCSW and Client, at to exchange information. NameTelephoneThe type of information to be disclosed:
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I hereby authorize helene is a form or document used to grant permission or consent to someone named helene.
Any individual who needs to give authorization to helene would be required to fill out and file the form.
To fill out the form, you would typically need to provide your name, signature, the reason for the authorization, and any other relevant information requested on the form.
The purpose of the form is to legally grant permission or consent to helene for a specific purpose or action.
The form may require information such as the authorized party's name (helene), the reason for authorization, the duration of authorization, and any other details deemed necessary.
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