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Directory Results for AUTHORIZATION FOR RELEASE OF CONFIDENTIAL INATION I, , hereby authorize Vascular Vein Centers to release all medical, psychiatric, alcohol and/or drug abuse, HIV testing, ARC and/or AIDS diagnosis and information to the following to AUTHORIZATION FOR RELEASE OF CONFIDENTIAL INATION MAINTAINED BY DISABLED STUDENTS PROGRAM AND SERVICES AT CHAFFEY COLLEGE - chaffey

AUTHORIZATION FOR RELEASE OF CONFIDENTIAL INATION I, , hereby authorize Vascular Vein Centers to release all medical, psychiatric, alcohol and/or drug abuse, HIV testing, ARC and/or AIDS diagnosis and information to the following
AUTHORIZATION FOR RELEASE OF CONFIDENTIAL INATION I, of (Patients Name) (Address) (City, state) (Zip code) Patients Date of Birth: authorize: SILVER PSYCHIATRICS SERVICES/ Randie Schacter, DO 212 W Matthews St
AUTHORIZATION FOR RELEASE OF CONFIDENTIAL INATION MAINTAINED BY DISABLED STUDENTS PROGRAM AND SERVICES AT CHAFFEY COLLEGE - chaffey
AUTHORIZATION FOR RELEASE OF CONFIDENTIAL INATION MAINTAINED BY DISABLED STUDENTS PROGRAM AND SERVICES AT CHAFFEY COLLEGE - chaffey