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David Tarullo, LCSW, LCADC, CSATC 7505 New La Grange Rd. Suite 101 Louisville, KY 40222 david@revolutionincounseling.com (502) 2766249AUTHORIZATION FOR RELEASE/REQUEST OF INFORMATION/RECORDS I, ___DOB:___hereby

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Revisions for release of are changes made to a previously submitted document or plan before it is finalized and released.

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Revisions for release of should be filled out by making note of the changes made to the original document or plan, as well as providing an explanation for why the changes were necessary.

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The purpose of revisions for release of is to ensure that any changes made to a document or plan are properly recorded and approved before it is released.

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Revisions for release of should include details of the changes made, the date they were made, and the reason for the changes.

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