OMB control number

Authorization to Release Medical Report to Physician

OMB 0960-0761 · SSA.

OMB 0960-0761

Latest Forms, Documents, and Supporting Material

Document Name
Form SSA-91 Authorization to Release Medical Report to Physician Form Form
0960-0761 supporting statement (2010).docx Supporting Statement A
Addendum.doc Supplementary Document
Authorization to Release Medical Report to Physician Form Form

All Historical Document Collections

201006-0960-011 Approved without change	Revision of a currently approved collection	2010-09-14
200704-0960-010 Approved with change	Existing collection in use without an OMB Control Number	2007-06-21