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Authorization to Release a Medical Certificate

catalogue.servicecanada.gc.ca

claiming EI Compassionate Care benefits. I am legally authorized to consent to release this patient's medical information. The patient is unable to consent to the release of medical information. I authorize my doctor or nurse practitioner to release my medical information to Employment and Social Development Canada (ESDC) and to all my

  Medical, Certificate, Release, Authorization, Compassionate, Authorization to release a medical certificate

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