Directory Results for AUTHORIZATION FOR RELEASE OF INATION I, SSN: , hereby authorize the release of and/or exchange of information including the review of copies of all medical, vocational, and other related records and to discuss pertinent information with to AUTHORIZATION FOR RELEASE OF INATION I, The Undersigned, Authorize: Name of Facility: Address: City, State, Zip: To Release Information from the Records Of: Patient Name: Patient Date of Birth: Patient Social Security Number: To Release