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AUTHORIZATION AND RELEASE OF MEDICAL
Workers Compensation. Your health information may be disclosed for workers compensation, as authorized by, or to the extent necessary to comply with, state.
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oc110a.pdf - Workers Compensation Board
Authorization for disclosure of records for certain purposes is not valid under the law. See excerpt of WCL Section 110-a on the reverse of this form. This.
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Workers Authorization Health Records
THIS AUTHORIZATION IS LIMITED TO USE AND DISCLOSURE OF. MEDICAL RECORDS AND DOES NOT WAIVE ANY PATIENT DOCTOR PRIVILEGE WITHOUT MY SEPARATE AUTHORIZATION AND
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