Document
DD Form 2870, Authorization for Disclosure of Medical or Dental Information, December 2003
ICR 201112-0720-001 · OMB 0720-0054 · Object 34451801.
Document Viewer [pdf]
Status: Original and derived artifacts are available for this document.
Download: pdf
Loading document viewer…
Document Metadata
| File Type | application/octet-stream |
|---|---|
| File Title | DD Form 2870, Authorization for Disclosure of Medical or Dental Information, December 2003 |
| Author | WHS/ESD/IMD |
| File Modified | 2009-06-04 |
| File Created | 2003-12-30 |
| Conversion State | complete |