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IHS Form 912-2, Request for Revocation of Restriction(s)

ICR 201908-0917-001 · OMB 0917-0030 · Object 94211201.

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application/vnd.openxmlformats-officedocument.wordprocessingml.document
IHS Form 912-2, Request for Revocation of Restriction(s)
OMB Approved HIPAA Public Use Forms
IHS
2021-01-15
partial