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Get the free Authorization for Release of Health Information

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Complete this essential form to authorize Mindful Therapy Group to share your health information. Required for coordination of your care, especially for adolescents.
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Authorization for release refers to the formal permission granted by an individual allowing their personal information to be disclosed or used by specified parties.
Individuals whose personal information is being disclosed or used need to file the authorization for release.
To fill out authorization for release, individuals should provide their personal details, specify what information is being released, identify the parties to whom the information will be released, and sign the document.
The purpose of authorization for release is to ensure that individuals have control over their personal information and that it is only shared with consent.
The information that must be reported includes the individual's name, the specific information to be released, the purpose of the release, and the contact information of the parties involved.
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