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Directory Results for I HEREBY AUTHORIZE SAN PATRICIO COUNTY TO INITIATE CREDIT ENTRIES AND to I hereby authorize the Calhoun City School System and the Calhoun Police Department to receive any criminal history record information pertaining to me, which may be in the files of any state or local criminal justice agency in Georgia

I HEREBY AUTHORIZE SAN PATRICIO COUNTY TO INITIATE CREDIT ENTRIES AND

I hereby authorize Sangamon Valley Public Water District, hereinafter called COMPANY, to initiate debit entries to my account indicated below and the financial institution named below, hereinafter called FINANCIAL INSTITUTION, to debit the

I hereby authorize SCC to initiate credit entries, and if necessary, debit entries and - stchas

I hereby authorize School District No

I hereby authorize school officials to send official student recordstranscript for the following student - wcpss

I hereby authorize Scott Credit Union to transfer funds electronically via ACH at the Financial Institution named below

I hereby authorize Scott Hansen, ARNP or ECMA trained, certified staff to perform light based hair reduction on me

I hereby authorize ServeMinnesota Action Network (Action Network) to initiate automatic deposits to my

I hereby authorize SHADOWFAX to initiate credit entries and initiate, if

I hereby authorize Shaker Veterinary Hospital, PC to provide emergency medical care as may be deemed necessary while my pet is boarding at this facility

I hereby authorize SHELBY COUNTY BOARD OF EDUCATION to initiate credit entries and to initiate, if - shelbyed k12 al

I hereby authorize Shenandoah Area Agency on Aging and its designated agents and

I hereby authorize Shenandoah County School Board , hereinafter called Company, to initiate credit entries and - shenandoah k12 va

I hereby authorize Sheraton Mallorca Arabella Golf Hotel to charge to my credit card with the amount

I hereby authorize Sheraton Waikiki Resort restaurants to charge my credit card (Circle)

I hereby authorize Show Management Convention Services (SMCS) to use the credit card account

I hereby authorize Simplicity Health Plans*, its agents, subsidiaries andor its business associates to disclose the

I hereby authorize Sincere Home Care to initiate automatic deposits to my account at the financial institution

I hereby authorize Singapore Badminton Association to

I hereby authorize Singapore Badminton Association to charge

I hereby authorize Sitel Operating Corporation and any of its affiliates, parent or subsidiary organizations,

I hereby authorize Skin Specialists of Allen, PA to release the information requested:

I hereby authorize Southboro Medical Group to release protected health information, including copies of the medical record of the

I hereby authorize Southcoast Health to disclose the following protected health information from the medical record of the patient listed below

I hereby authorize Southern Illinois University Edwardsville to deduct the amount indicated on this card from

I hereby authorize Southern Surgical amp Medical

I hereby authorize Southlake Family Medicine to disclose my individually identifiable health information as described below,

I hereby authorize Southwest Pharmacy Solutions, Inc - aprx

I hereby authorize Southwestern Illinois College to initiate credit entries and to initiate, if

I hereby authorize SPE Federal Credit Union, hereafter called Credit Union, to initiate debit entries to my

I hereby authorize Sports & More Physical Therapy by ACCESS PT to release information on my therapy treatment and

I hereby authorize SpringThyme Marketing to charge my credit card for payment on rental space for

I hereby authorize staff and management of the Princeton ...

I hereby authorize staff of Parsons Counseling, LLC. to ...

I hereby authorize staff to administer the medication

I hereby authorize Stafkings of Binghamton, Inc., hereinafter called ...

I hereby authorize Sterling Health Services Administration andor Fidelity National Information Services

I hereby authorize Stowell Learning Center and the following parties to exchange any reports

I hereby authorize Strategic Merchant Solutions to initiate credit/debit entries to my Checking or Savings account selected below at the Financial Institution indicated, to credit/debit such account

I hereby authorize student to participate in the offcampus field trip and all related activities - ashmi

I hereby authorize Sunstreet Mortgage, LLC to order a Consumer Credit Report and verify other credit

I hereby authorize Superior Staffing, Inc

I hereby authorize Sweetland Ltd

I hereby authorize Talos Solutions to initiate automatic deposits to my account at the financial institution named

I hereby authorize Tanaz Sadeghi, Licensed Marriage & Family Therapist (MFT

I hereby authorize Tar River Baptist Association to verify all information, other written - tarriverbaptist

I hereby authorize TDance School Of Performing Arts

I hereby authorize TEAM Physical Therapy, P

I hereby authorize Tennessee Technological University to initiate credit entries and to initiate, if necessary, debit entries and adjustment for any credit entries in error to my account(s) indicated below and I authorize the depository named below

I hereby authorize TEP Barnett USA, LLC

I hereby authorize testing and confirm that informed

I hereby authorize Texas Back Institute the use or disclosure of my individually identifiable health information as

I hereby authorize Texas Emergency Medical Services to release to - mytexasems

I hereby authorize Texas FAIR Plan Association to initiate credit entries (deposits) and adjustments for any

I hereby authorize Texas Homes Realty & Management to initiate automatic debits from my account from the financial institution named below

I hereby authorize Texas Womans University (University), and those acting pursuant to

I hereby authorize that my protected health information be forwarded:

I hereby authorize that my transcript be released to - beaufortccc

I hereby authorize that such health information regarding the above-named person be forwarded:

I hereby authorize that the designated (indicated by checking yes) listed below may be contacted verbally or by written correspondence regarding my personal medical information, as it relates to injury or illness and my participation in

I hereby authorize that the following information may released for use by St

I hereby authorize that the health information regarding the above named person be forwarded

I hereby authorize that the information requested below be given to the Housing

I hereby authorize that the protected health information regarding the above named person be forwarded:

I hereby authorize that the protected health information regarding the abovenamed person be released from - ric

I hereby authorize the - kidsports

I hereby authorize the above clinical professional staff to release all medical information

I hereby authorize the above individual, company, or institution to furnish Century Protective Services Inc

I hereby authorize the above named facility, any parent company, and any other any health plan, physician,

I hereby authorize the above named facility, any parent company, and any other any health plan, physician, health care

I hereby authorize the above named physician or any physician designated by him/her, providing care to the above named patient to render such care

I hereby authorize the above stated personfacility to release the br

I hereby authorize the above-referenced entity to release the medical information about me indicated below to the following recipient:

I hereby authorize the Administrators of the Attorney Registration and Disciplinary Commission, and/or the disciplinary and inquiry bodies of any bar association to disclose to the Alliance of Bar Associations for Judicial Screening

I hereby authorize the adults responsible for the event to secure such medical advice and services as may be deemed necessary for the health and safety of my child or ward in the event of an emergency

I hereby authorize The Alaska Center for Pain Relief, or any of its employees, staff, or

I hereby authorize The Alpha Center to release my confidential health information to the following Designee:

I hereby authorize the Alzheimer Society of B

I hereby authorize the American Association of Neuroscience Nurses, hereinafter called AANN, to initiate direct deposit to our chapters bank account at the depository named below of chapter dues reimbursement checks on a quarterly basis (i

I hereby authorize the American Dental Association to initiate credit entries and if necessary, debit entries to adjust for any credit entry errors, to my account below, and the participating institution named below to credit the same to

i hereby authorize the American Postal Workers Union in ...

I hereby authorize the amount of my GRM Networks bill to be paid by automatic

I hereby authorize the and its authorized representatives bearing this release, or a copy thereof, within one year of its date, to obtain any information in your files pertaining to my employment, military, credit, education or medical

I hereby authorize the Archdiocese of Dubuque, St Patrick Parish, and

I hereby authorize the Archdiocese of Dubuque, the host parish(es), and their

I hereby authorize the athletic trainer and other health care personnel representing , (name of

I hereby authorize the athletic trainer and other health care personnel representing BOLD High

I hereby authorize the AtlantiCare entity indicated below - atlanticare

I hereby authorize the AtlantiCare entity indicated below:

I hereby authorize the AZ Scitech Festival to publish the videos taken of the undersigned minor child, and

I hereby authorize the bAdair Countyb Family YMCA to initiate bb

i hereby authorize the bearer

I hereby authorize the below listed Company, hereinafter called COMPANY, to initiate credit entries and

I hereby authorize the Berkshire Medical Center Fairview Hospital Medical Record Department or other entity

I hereby authorize the Blue Ridge Judicial Circuit Drug Accountability Court and its - cscj

I hereby authorize the Board of Regents of the Nevada System of Higher Education on behalf of the

I hereby authorize the Borough of Lodi and the Lodi Police Department to procure medical treatment for me in the case of an emergency at my own cost and expense

I hereby authorize the Boston Architectural College (BAC) to deposit any amounts owed me by initiating credit entries - the-bac

I hereby authorize the Calabasas Chamber of Commerce to place an advertisement on the

I hereby authorize the Calhoun City School System and the Calhoun Police Department to receive any criminal history record information pertaining to me, which may be in the files of any state or local criminal justice agency in Georgia