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2001 W. Blue Heron Blvd., Riviera Beach, FL 33404 Phone (561) 8413500 Fax (561) 8443577 Authorization To Obtain and Release InformationClient Name: ___ Date of Birth ___ MR# ___ This will authorize

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Go to the 'Contact Us' page on the community website

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Fill out the required fields such as name, email, subject, and message

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Verify that all the information provided is accurate

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What is contact us - community?

Contact us - community is a platform that allows individuals and organizations to reach out for support, inquiries, or information regarding community-related matters.

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Individuals and organizations who engage with community services or programs may be required to file contact us - community forms to ensure proper communication and support.

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The purpose of contact us - community is to facilitate communication between the community and its members, ensuring that inquiries are addressed promptly and effectively.

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The information that must be reported includes the requester's name, contact details, the subject of the inquiry, and any relevant details that provide context to the request.

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