Local Contact Agency Consent for the Release of Confidential Information - North Carolina

Local Contact Agency Consent for the Release of Confidential Information - North Carolina

Local Contact Agency Consent for the Release of Confidential Information is a legal document that was released by the North Carolina Department of Health and Human Services - a government authority operating within North Carolina.

FAQ

Q: What is the Local Contact Agency Consent for the Release of Confidential Information?
A: The Local Contact Agency Consent for the Release of Confidential Information is a form used in North Carolina to authorize the release of confidential information by a local contact agency.

Q: When is the Local Contact Agency Consent for the Release of Confidential Information needed?
A: This form is needed when you want to authorize a local contact agency in North Carolina to release your confidential information to a third party.

Q: Who needs to fill out the Local Contact Agency Consent for the Release of Confidential Information?
A: The person whose confidential information is being released needs to fill out this form.

Q: What information is required in the Local Contact Agency Consent for the Release of Confidential Information?
A: The form typically requires personal information of the individual, details of the information being released, and the name of the third party receiving the information.

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Form Details:

  • Released on March 1, 2014;
  • The latest edition currently provided by the North Carolina Department of Health and Human Services;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the North Carolina Department of Health and Human Services.

Download Local Contact Agency Consent for the Release of Confidential Information - North Carolina

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