Case Manager Release Form Name(Required) I hereby grant my permission for BANGORHOUSING, to release confidential information and material to the below named agency’s person.Case Manager/Other Contact(Required) Company Name Address Address Line 2 Office Phone NumberCell Phone NumberFax NumberEmail Address(Required) My signature on this release also allows the above-named agency’s person to release any confidential information and material to BANGORHOUSING. I understand that no such information or material will be released without this specific permission except where provided by law. I also understand that I have the right to review copies of any information or material released and to revoke this permission in writing at any time.Date(Required) MM slash DD slash YYYY Signature(Required) Reset signature Signature locked. Reset to sign again