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Authorization for Release of Medical and/or Ophthalmic Records Please complete the following information: Patient 's Name Date of Birth Address City, State, Zip I request and authorize to release all Medical and/or Ophthalmic records of the
Authorization for Release of Medical and/or Ophthalmic Records Please complete the following information: Patient 's Name Date of Birth Address City, State, Zip I request and authorize to release all Medical and/or Ophthalmic records of the
An application for lease should be filed in duplicate in the proper office. evidence that it is authorized to transact business in Alaska, and a copy of
Applications - DOG - Alaska Department of Natural Resources
Use the One-Time Extension Application to apply for a one-time lease extension under AS 38.05.180(m). The forms are available above for download in PDF or MS
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