VA256-14-R-1394 ATTACHMENT 14-VHA-10-5345-ROI TO OUTSIDE PARTIES.DOCX

Published: 07/31/2015

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SECTION D ATTACHMENT 14 OMB Number: 2900-0260 Estimated Burden: 2 minutes REQUEST FOR AND AUTHORIZATION TO RELEASE MEDICAL RECORDS OR HEALTH INFORMATION Privacy Act and Paperwork Reduction Act Information: The execution of this form does not authoriz...

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