Fillable Printable Property Rental and Lease Template

Property Rental and Lease Template

AUTHORIZATION FOR RELEASE OF LEGAL FILES

TO (fill in name and address of law firm):

You are hereby authorized to release any and all documents, including but

not limited to pleadings, correspondence, notes, medical records and reports,

investigative reports, and all other information written or otherwise recorded,

contained in the file of (or relating to my legal case involving)

_______________________________________, to the Law Firm of Carl Kiss,

888 S.W. Fifth Avenue, Suite 650, Portland, OR 97204, or to any representative,

attorney or investigator from said firm. I specifically authorize the release to said

individuals of information pertaining to confidential attorney-client

communications, medical treatment, drug and alcohol abuse and related

treatment, and psychological and psychiatric treatment, if such are a part of your

records.

THIS AUTHORIZATION HEREBY REVOKES ANY AND ALL PRIOR

AUTHORIZATIONS TO RELEASE INFORMATION CONCERNING ME,

EXCEPT AUTHORIZATIONS PROVIDED BY LAW. YOU ARE REQUESTED

TO DISCLOSE NO INFORMATION TO ANYONE ELSE WITHOUT MY PRIOR

WRITTEN AUTHORIZATION.

DATED this ____ day of ________________, 200__.

Client Signature

Client Name (Printed)