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TRAVIS COUNTY EMERGENCY SERVICES DISTRICT No. 2 PFLUGERVILLE FIRE DEPARTMENTAUTHORIZATION FOR RELEASE OF PROTECTED HEALTH INFORMATION (PHI) Form Number: ADM 018cOriginal Date: 05192017Patients/Subjects
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The authorization form is used to grant permission for certain actions or access.
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The form should include details about the action or access being authorized, as well as information about the authorizing party.
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