UCRS 158 - UCSB Human Resources - hr ucsb 2025

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The document is a consent form for the disclosure and use of health care and vocational information by the University of California Retirement Plan (UCRP) Disability Unit. It authorizes specific health care providers to share relevant records for evaluating eligibility for disability income benefits, while outlining restrictions on certain sensitive information. The authorization is effective immediately and lasts for two years, with provisions for revocation and privacy notifications regarding the handling of personal information.

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