102dlsc pdf 2025

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The document is a complaint form and authorization for release of information from the Wisconsin Department of Safety and Professional Services. It provides instructions for filing a complaint against health care professionals, detailing required information such as personal details of the complainant and patient, incident specifics, and necessary authorizations for accessing health care records. The document emphasizes the importance of providing comprehensive information to facilitate investigations.

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Versions	Form popularity	Fillable & printable
2015	4.9 Satisfied (513 Votes)
2014	4 Satisfied (39 Votes)

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