jafza authorization
License Authorization Form
Please complete this form and submit a copy of the appropriate license(s} to Customer Licensing by facsimile to 866-470-1355, by email to custlicense@sarnova.
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47 CFR 64.632 - Letter of authorization form and content.
Every letter of authorization must be translated into the same language as any promotional materials, descriptions or instructions provided with the letter of
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STANDARD AUTHORIZATION FORM
Records released pursuant to this authorization may include information concerning testing, diagnosis or treatment of HIV/AIDS, psychiatric and/or drug/alcohol
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