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Directory Results for Department of Health and Social Services Office of the Privacy Official PO Box 110650 Juneau, AK 998110650 AUTHORIZATION FOR RELEASE OF INATION Name: SSN: Record # or Other ID: Date of Birth: Other Names Under Which Records Might Be to DEPARTMENT OF HEALTH AND SOCIAL SERVICES PROFESSIONAL

Department of Health and Social Services Office of the Privacy Official PO Box 110650 Juneau, AK 998110650 AUTHORIZATION FOR RELEASE OF INATION Name: SSN: Record # or Other ID: Date of Birth: Other Names Under Which Records Might Be
DEPARTMENT OF HEALTH AND SOCIAL SERVICES PROFESSIONAL