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Directory Results for County of San Bernardino Department of Behavioral ... to County of San Bernardino Department of Behavioral Health AUTHORIZATION FOR RELEASE OF PROTECTED HEALTH INATION (PHI) Name of Client: Gender: Male / Date of Birth: Female / Social Security: XXXXX Client Address: (Month/Date/Year) (last 4

County of San Bernardino Department of Behavioral ...
County of San Bernardino Department of Behavioral Health - sbcounty
COUNTY OF SAN BERNARDINO DEPARTMENT OF BEHAVIORAL HEALTH ... - sbcounty
County of San Bernardino Department of Behavioral Health AUTHORIZATION FOR RELEASE OF PROTECTED HEALTH INATION (PHI) Name of Client: Gender: Male / Date of Birth: Female / Social Security: XXXXX Client Address: (Month/Date/Year) (last 4