Sealed Medical and Health Information (Cover Sheet) Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Sealed Medical and Health Information (Cover Sheet) Form. This is a Washington form and can be use in General Statewide.
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Tags: Sealed Medical and Health Information (Cover Sheet), WPF 01.0300, Washington Statewide, General
Court of Washington County of In re: No. Petitioner(s)/Plaintiff, and Sealed Medical and Health Information Cover Sheet under GR 33 (SMHI) Clerk's Action Required: Only the court and person requesting accommodation may have access to this information without a court order Respondent(s)/Defendant(s). (File in the proceedings file, if there is one, or the administrative file.) Sealed Medical and Health Information Attached are documents that contain information about the physical or mental health condition of a person requesting an accommodation under GR 33. Submitted by: Signature Print Name Sealed Medical and Health Info Cover Sheet under GR 33: (SMHI) - Page 1 of 1 WPF All Cases 01.0300 (02/2015) GR 33(b)(5) American LegalNet, Inc. www.FormsWorkFlow.com