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Consent for Release and Exchange of Confidential
I,. , authorize the following information to be disclosed and re- disclosed as necessary to evaluate my need for services and to coordinate those services being
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Long-Term Drug Supply Chain Security Information
Requests for confidential commercial information: FDA must determine if (1) the owner of the information or sponsor for the product application has provided.
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Authorization to Release / Exchange Confidential Information
This is necessary to ensure that the information is released exactly to whom you intend. For your protection, if this information is incomplete or is illegible,
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