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Release of Health Information
Click to view (pdf or doc)
For UK employees only. Authorize an individual to contact the HR Benefits office and receive information regarding UK benefits on employee’s behalf.
Revision date: 04/04/2019
Submit paper form to 112 Scovell Hall, 1080 Export St Ste 280, Fax 859-323-1095
Email form back to firstname.lastname@example.org