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F HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION The Individual named below has filed an application for a period of disability and/or disability payments. If you complete this form, your patient may be able to receive early payments. (This Is not a request for an examination, but for existing medical information.) MEDICAL RELEASE INFORMATION Form SSA-827, ''Authorization to Release Medical Information to the Social Security Administration,'' attached. I hereby authorize the medical source named b.

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