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This Form Is To Be Used By A Patient Or Legal Representative To Authorize The Release Of Information To A Third Party (Other Than A Family Member Or Friend) Such As An.

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A Medical Waiver Or Exemption Allows You To Operate Commercial Vehicles Even If You Don't Meet The Minimum Federal Medical Requirements.

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Web Treatment Research Medical Hardship Waivers Legal Investigation Or Action Insurance Eligibility/Benefits Other (Specify):

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