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I hereby authorize the release of confidential medical and/or other information to the Department of Insurance. I understand that medical records WILL NOT be public at any time.
Reminder: Please do not include Social Security Numbers.
Your complaint will be kept on file at the Department of Insurance and will become a public record. If you need to send us confidential information (for example, medical records), please send copies of your original documents to us by regular mail. The regular mail address is located here.
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