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CONSENT TO RELEASE AND OBTAIN INFORMATION
Federal law requires DOR to release some personal information to other state agencies in order to match data, such as wage records, for federal performance
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Consent for Release of Information - Social Security
We may charge a fee to release information for non-program purposes. Fill in your name, date of birth, and social security number or the name, date of birth,
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Authorization to Release Test Results to a Designated Third
The purpose of this form is to authorize Foundation Medicine to release patient information or test results to a designated third party.
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