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Plainfield Police Department Honorable ServiceChief of Police, Mario A. Marriage 210 Norwich Rd. Plainfield, CT 06374 (860)5640804 fax (860)5640808www.plainfieldctpolice.citizen COMPLAINT FORM Effective
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03
Clearly state the purpose of the authorization.
04
Include your full name, contact information, and any relevant identifiers such as a social security number or patient ID.
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Who needs authorization to release information?

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Authorization to release information may be required by various individuals or organizations such as healthcare providers, insurance companies, government agencies, employers, schools, and legal entities.
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Authorization to release information is a document that allows one party to disclose a specific individual's personal information to another party.
Anyone who wants to share an individual's personal information with another party is required to file authorization to release information.
To fill out authorization to release information, one needs to provide their personal information, specify the information to be released, and sign the document.
The purpose of authorization to release information is to legally allow the sharing of an individual's personal information between parties.
The information that must be reported on authorization to release information includes the individual's name, date of birth, specific information to be released, and the parties involved.
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