Phone: 810-555-1111

Forms - Academic Release of Information

Home   Forms   Academic Release of Information
Academic Release of Information (File: AUTH FOR RELEASE OF ACADEMIC INFORMATION.pdf)
Date Posted: 01/07/16
Employment Records Authorization (File: EMPLOYMENT RECORDS AUTHORIZATION.pdf)
Date Posted: 10/05/15
General Release (File: GENERAL RELEASE.pdf)
Date Posted: 08/31/15
Medical Records Release Form (File: AUTH FOR RELEASE OF MEDICAL RECORDS.pdf)
Date Posted: 01/08/16
Order Form (File: ORDER FORM.pdf)
Date Posted: 10/06/15
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Legal-Ease Digital Imaging, LLC, PO Box 1017, Flint, MI 48501-1017 | Phone: 855-534-4003 / 810-234-7799 | Fax: 810-547-4030

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