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Get Release Of Information Form Mental Health Template

Bend Mental Health Counseling Carol Hopwood LCSW 548 SW 13th Street Suite 202 Bend, OR 97701 5414104107 CarolHopwoodLCSW gmail.comAUTHORIZATION FOR USE OR DISCLOSURE OF PROTECTED HEALTH INFORMATION.

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  7. Click Done and save the resulting document.

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