This form allows the Member to authorize the Kindness Initiative to release or exchange personal information, with qualified Service Providers. As a Member, you can choose what information you would like us to share. This form eliminates the the burden of your filling out release forms repeatedly, for multiple Service Providers, and may speed up the process of obtaining needed services. You choose what information you authorize the Kindness Initiative to disclose, to whom, and for how long. You are not required to complete this form, and may wait to complete it until it is needed.
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