You're responsible—to the best of your knowledge—for providing accurate, complete, and up-to-date information about your health. I, or my authorized representative, request that health information regarding my care and treatment be released as set forth on this form:.Purpose: This form authorizes the school to administer prescribed medication to your child during school hours. If you are unable to resolve your dispute with the merchant, fill out the Dispute Transactions under the Account Services Tab and follow the prompts. The book grew out of a 2017 essay Rieder published in Health Affairs titled "In Opioid Withdrawal, With No Help in Sight. Some recommendations are included to help clinicians make decisions about services and levels of care for individuals at risk for or experiencing withdrawal.