Authorization Release Records

State:
Minnesota
Control #:
MN-8430D
Format:
Word; 
Rich Text
Instant download

Description

This form is an Authorization to Release Treatment Records, Reports, and other Information. The client understands that he/she may revoke this consent at anytime and upon fulfillment of the purpose stated in the document, the consent will automatically expire without the client's express revocation.
Free preview Revocation Of Authorization Form Minnesota
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Authorization Release Records