Get the free doh form 5032

Description
STAFF PERSON S NAME AND TITLE SIGNATURE This form may be used in place of DOH 2557 and has been approved by the NYS Office of Mental Health and NYS Office of Alcoholism and Substance Abuse Services to permit release of health information. However this form does not require health care providers to release health information. Alcohol/drug treatment related information or confidential HIV related information...
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doh form 5032
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