Authorization to Furnish / Release Information

Department of Social Services

This government document is issued by Department of Social Services for use in South Dakota

Add to Favorites
File Details: DOCX
Downloads: 20
Source
http://dss.sd.gov/formsandpubs/docs/MEDELGBLTY/208AuthorizationReleaseInformation.docx
Tags
  • Medical Eligibility

Have Questions About This Form?
Ask An Expert For Help:

Questions and comments are moderated. Minimum of 10 characters.

All questions and comments are moderated and publicly viewable. Please do not post private or sensitive information such as names, addresses, phone numbers, emails, confidential financial and legal details.

Login or sign up to submit questions