Authorization for Disclosure
For a copy of an AFD, please call the number on your ID card or call (800) 327-0010.
For non-English versions of this form, please call Member Services at (888) 426-0023.
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For a copy of an AFD, please call the number on your ID card or call (800) 327-0010.
For non-English versions of this form, please call Member Services at (888) 426-0023.