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Client Name (First, Middle, Last): *Print Neatly×County of Sacramento AUTHORIZATION TO OBTAIN OR RELEASE PROTECTED HEALTH INFORMATION (PHI) CONTACT:Date of Birth: Address: City/State/Zip Code: Phone
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County of Sacramento client-initiated refers to a process or service initiated by a client within the jurisdiction of Sacramento County, often concerning legal, administrative, or social services.
Individuals or entities seeking specific services or involvement with county programs may be required to file a client-initiated request or application.
To fill out the form, you need to provide relevant personal information, purpose of the request, and any required supporting documentation as specified by the county guidelines.
The purpose is to allow clients to request services or interventions from county government, facilitating access to needed resources and assistance.
Information typically required includes personal identification, contact details, the nature of the request, and any relevant background information.
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